2025-2026 Wakeman Boys & Girls Club Adult Volunteer Application

2025-2026 Wakeman Boys & Girls Club Adult Volunteer Application

Version 081325
Full Name (as seen on your formal documents)*

First NameLast Name
Preferred Name/Nickname
Date of Birth*

MonthDayYear
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone

Area CodePhone Number
Cell Phone*

Area CodePhone Number
E-mail*
Preferred Method of Communication*

Home PhoneCell PhoneEmail
High School (including town, state)
Graduation Year
College (including state)
Graduation Year
Degree/Major
Additional College (including state)
Graduation Year
Degree/Major
Current or Most Recent Employer*
Your Position/Role*
Are you currently employed by this company?*

YesNo
Location (Town, State)*
Dates Employed*
Other Potentially Relevant Training or Certifications to Volunteering at Wakeman
I was referred to Wakeman by
Are you a Boys & Girls Club alumnus?*

Yes, I am an alumnus of Wakeman Boys & Girls ClubYes, I am an alumnus of a different Boys & Girls ClubNo
Name of Boys & Girls Club you are an alumnus:
If you need volunteer service hours to fulfill a requirement, please describe program requiring hours, the number of hours needed, and completion deadline
When Are You Available?
How many hours per week are you available to volunteer?*
Please select the day(s) you are available to volunteer*

MondaysTuesdaysWednesdaysThursdaysFridaysSaturdaysSundays
Please select the times of day you are available to volunteer (activities listed after time range are a sample of typical activities taking place at this time)*

Mornings/Early Afternoons (9:00am - 2:30pm: maintenance/handiwork, administrative support, fundraising event committees)After School Hours (3:00pm - 4:00pm: programs such as homework help, art classes, fitness activities and teen programs)After School Hours (4:00pm-5:00pm: programs such as homework help, art classes, fitness activities and teen programsAfter School/Early Evening Hours (5:00pm-6:00pm: programs such as homework help, art classes, fitness activities and teen programs, and early evening programs such as basketball coaching)Evenings (6:00pm - 9:00pm: basketball coaching, teen programs)Weekends (basketball coaching, teen programs)
At which location are you interested in volunteering?*

No PreferenceSouthport Clubhouse, 385 Center Street, SouthportMcKinley School Based Program, 60 Thompson Street, FairfieldMadison Avenue Clubhouse, 595 Madison Avenue, BridgeportSmilow-Burroughs Clubhouse, 2414 Fairfield Avenue, Bridgeport
What are your interests or talents?*

ArtsBasketballTeen LeadershipField HockeyDance, YogaLacrosseTutoring/HomeworkHealthFitness TrainingGame RoomComputers, TechCollege PrepMentoringFundraising EventsMaintenanceEngineeringAdministrativeOther (Please describe below)
Please list any other interests or talents you would like to include
Character References

Please include three references.
1. Name of Personal Reference (friend, neighbor, relative)*

First NameLast Name
Phone Number

Area CodePhone Number
Phone Number

Area CodePhone Number
E-mail
example@example.com
Length of time this person has known you:
2. Name of Professional Reference (co-worker/supervisor/associate)*

First NameLast Name
Phone Number

Area CodePhone Number
E-mail
Length of time this person has known you:
3. Name of Professional or Personal Reference*

First NameLast Name
Company Name
Length of time this person has known you:
Title
Phone Number

Area CodePhone Number
Email of Professional Reference
Wakeman Boys & Girls Club may require you to take a drug test. If asked, are you willing to take a drug test?*

YesNo
Service Requirements & Background Check

As a volunteer, I understand that it is my responsibility to keep track of my own service hours. I will also notify the volunteer coordinator to the best of my ability in the event of any absence.

I attest that the above information is correct. I authorize investigation of all statements contained in this profile and understand that any false information is cause for termination of my volunteer role at Wakeman Boys & Girls Club. I further authorize Wakeman Boys & Girls Club to receive any criminal history record/information pertaining to me which may be on file with the local or state Criminal Justice Agencies. I understand Wakeman Boys & Girls Club is a drug free and smoke free working environment. Any use of drugs and or alcohol is cause for dismissal.

I understand that after a review and initial acceptance of my application, I will receive an email prompting me to complete a background check application. I understand completion of a background check is required of all volunteers, but does not guarantee acceptance for a volunteer position at Wakeman Boys & Girls Club
Please enter your full name below indicating the information you have submitted is correct and you agree to the above statements.*
Volunteer Safety Expectations

Wakeman Boys & Girls Club (WBGC) expects all employees and volunteers to conduct themselves in a manner which is in the best interests of the organization, its members and its employees. Employees and volunteers should know that any conduct which violates a WBGC policy, or which is not in the best interests of WBGC, will subject an employee or volunteer to discipline, up to and including separation with or without notice. Disciplinary actions are noted in the employee’s personnel file and volunteer records.

WBGC has established policies and procedures for the convenience and protection of all its employees and volunteers. A violation of any of these policies and procedures is considered misconduct and appropriate disciplinary procedures will be initiated. Disciplinary action may include, but is not limited to, the following: verbal warning, written warning, suspension without pay and separation. There is no guarantee that one form of disciplinary action will necessarily precede another. The appropriate disciplinary action will be determined by the Unit Executive Director, direct supervisor and/or the CEO.

The following includes but is not limited to some of the more common examples of policy violations & misconduct:

·       Any one-on-one interaction with a WBGC member that is not held in an open setting;

·       Failure to follow child abuse state mandatory reporting laws;

·       Disclosure of confidential WBGC, WBGC member or employee/volunteer information to unauthorized parties;

·       Supplying false or misleading information in an employment or volunteer application or elsewhere, or falsifying any WBGC record;

·       Possession of weapons on or off premises while performing duties for the WBGC;

·       Immoral or indecent conduct; soliciting persons for immoral purposes;

·       Insubordination, including but not limited to, refusing to obey an order or directive of a supervisor or WBGC official;

·       Disruptive conduct, including but not limited to gambling; fighting; horseplay; coercion; intimidation or threats against WBGC employees or volunteers; vulgarity; or, abusive treatment of the public, fellow employees, volunteers, or WBGC members;

·       Theft or unauthorized possession or removal of property or money belonging to WBGC, employees, volunteers, members or third parties;

·       Making or publishing false, vicious or malicious statements concerning an employee, volunteer, member, supervisor, or other WBGC official, or WBGC services;

·       Excessive tardiness, absenteeism, or leaving early; or leaving work area without permission;

·       Destruction or misuse of property or equipment;

·       Failure to comply with WBGC policies and procedures;

·       The unlawful manufacture, distribution, dispensing, possession or use of an illegal or controlled substance on or in WBGC property;

·       Conviction of a felony;

·       Performing work of substandard quality or quantity; or

·       Violation of fire or safety regulations.

The above list is not all-inclusive. Employees and volunteers are expected to perform their duties with integrity, good sense, dignity and courtesy.
Please enter your full name below indicating the information you have submitted is correct and you agree to the above statements.*
Date

MonthDayYear
If you are completing this form at the request of a specific Wakeman Boys & Girls Club director, please list that director's name here:
Enter the message as it's shown*
Should be Empty:

2025-2026 Wakeman Boys & Girls Club Adult Volunteer Application

When Are You Available?

Character References