Interested in joining Bubbles And Hope Laundry Club?
Tell us a little about yourself & we will be in touch. Please note, filling out this form does NOT commit you to anything -- this just helps us to know who is interested in learning more about being involved with Laundry Club so that we can be sure to share that information with you!
Name
*
First Name
Last Name
Age
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred method of contact
*
Email
Phone call
Text
No preference
How do you like to communicate?
*
Verbal
Sign language
Gestures/facial expressions
AAC device
Other
Are you applying to be a Laundry Club member or a Peer Mentor? Laundry Club members are those who are interested in working on social & vocational skills. Peer Mentors come alongside LC members to encourage & support learning social & vocational skills.
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Laundry Club Member
Peer Mentor
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Have you ever participated in a job skills training program, either in the past or currently?
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Yes
No
Have you ever been employed (been paid to do a job), either in the past or currently?
*
Yes
No
Do you have access to reliable transportation?
*
Yes
No
Tell us a little about yourself (anything you want to share, whether it's about your disability, your hobbies, your favorite food, anything!)
Are you a parent or caregiver filling this out for someone else? If so, what is your name & relationship to this individual?
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Do you have any experience serving in a mentoring role and/or working with individuals with disabilities? If yes, in what capacity?
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Why are you interested in being a peer mentor?
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Thank you so much for your interest!
We look forward to learning more about you! We will be in touch.
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