ESL @ LCOS

ESL @ LCOS Volunteeer Application Form

Thank you for your interest in volunteering with the ESL Program at the Lutheran Church of Our Savior. The information youbprovide will be stored in confidence, Your completed form will be hel securely and confidentially. Only authorized staff will have access to your information.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Employer/Former Employer
Birthday:(month & day only)
If you are involved with us as a volunteer and an emergency arises, whom should we contact?
Relationship
Telephone
Email
What kind of voluntary work interests you? Check all that apply

ESL TeacherESL Teacher AideESL SubstituteChildren's Program AssistantESL Advisory Board Member
When are you available for voluntary work? Check all that apply>

Tuesdays/Thursdays 9:00 am-11:00 amTuesdays/Thursdays 6:30 pm-8:30 pmFall Session (September-November)Winter Session (January-March)Available for Board Meetings (January-December)
References (1)
Relationship
If applicable-Employer
Position
Type a question
Phone Number
Please enter a valid phone number.
Email
example@example.com
Reference (2)
Relationship
If applicable-Employer
Position
Phone Number
Please enter a valid phone number.
Email
example@example.com
The ESL Program at the Lutheran Church of Our Savior in Rehoboth Beach is committed to eual opportunities, and all volunteer recruitment decisions will be based on merit, suitability for the role and experience. All volunteer recruitment decisions will not be influenced by race, color, nationality, religion, sex, marital status, family status. sexual orientation, disability, or age. The Lutheran Church of Our Savior fully endorses a working environment free from discrimination and harrassment

I declare that the information I have provided is true. I hereby certify that the facts contained in this application are true and complete to the best of my knowledge. All my actions as a volunteer will reflect the ethos of the Lutheran Church of Our Savior.
Signature/Date

Clear
For office use only
Volunteer Position
Volunteer Interview
References Collected
Volunteer Start Date
Should be Empty:

ESL @ LCOS Volunteeer Application Form