Language
English (US)
2023 Volunteer Application
Rev. 12.2022
PROGRAMS WILL BE IN-PERSON!
**Face masks are required in the building regardless of being fully vaccinated.**
How did you hear about Mission: City?
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Volunteering for:
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Tutoring & Mentoring
Administrative Assistant
Program Admin (Wed, Thurs. Fri, and/or Sat)
Summer Program Staff
Preferred Grade Level for Tutoring (Check all that apply)
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K-2nd
3rd-4th
5th-6th
7th-8th
Areas of Strength (Check all that apply)
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Math
Reading
Science
Social Studies/History
English
Which day(s) are you interested in volunteering for?
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Name
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First Name
Last Name
Phone Number
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Please enter a valid phone number.
Email
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example@example.com
Date of Birth
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-
Month
-
Day
Year
Date
Unisex Shirt Size
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Small
Large
XL
XXL
Other _________
Other
Home Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Employer (If Retired, indicate previous employer)
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Position
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Work Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please list any languages that you speak, read and/or write fluently, in addition to English
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Have you had experience as a volunteer?
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Yes
No
If you checked yes, please specify below:
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Upload a Photo ID (required)
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Please describe any work or personal experience you think might be relevant to our program:
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Do you have any hobbies or special talents?
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References
Please provide info for three references
Name #1
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First Name
Last Name
Phone Number
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Please enter a valid phone number.
Time Known
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Relationship
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Name #2
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First Name
Last Name
Phone Number
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Please enter a valid phone number.
Time Known
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Relationship
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Phone Number
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Please enter a valid phone number.
Have you ever been charged with or convicted of the following:
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N/A
A Felony?
Any crime involving a sexual offense, an assault or the use of a weapon?
Any crime involving the use, possession or the furnishing of drugs?
Reckless driving, operating a motor vehicle while under the influence?
If you selected any of the above four items, please explain.
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Mission: City has my permission to:
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Yes
No
Run a background check
Run a motor vehicle records check on me if I decide to operate a MC vehicle
Verify the 3 references I have provided
Take and publish photographs and/or videos of me for program promotiona
Please provide your last 4 digits of SSN
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Signature
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By signing above, I affirm that I have answered all questions truthfully. I understand that if any portion of this application is found to be intentionally false, I may be denied the right to volunteer for Mission: City.
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