Clone of ALP Volunteer Form

Volunteer Form

Study Buddy Program @ Great Plains Elementary K-5 School
Full Name

First NameLast Name
Date of Birth

MonthDayYear
SSN
If under 18 year old, enter your date of birth again
Phone Number
Format: (000) 000-0000.
Email Address
Current Address
School or Business Address
Highest level of education:
Home church (optional):
Name & City
Are you volunteering through another organization (like your school, sorority, job, etc)
If yes, what organization

Name of OrganizationContact PersonPhone number or email of contact person
Volunteer Preferences
Check all time slots you are available
Check all days available:
Add details about your availability or flexibility here
Can you perform the essential functions of the job for which you have applied, with or without reasonable accommodation?
Volunteer/Job Experience
Most Recent Job or Volunteer Experience:
(E.g. Summer Camp, VBS, Lifeguard, Babysitter, Tutor)
Job or Volunteer Experience # 2:
(E.g. Summer Camp, VBS, Lifeguard, Babysitter, Tutor)
Job or Volunteer Experience # 3:
(E.g. Summer Camp, VBS, Lifeguard, Babysitter, Tutor)
References
Please provide 3 references, [not relatives] having knowledge of your character, experience and work habits. Reference can be a pastor, mentor, manager, boss, teacher, guidance counselor, etc
Please provide answer in this format: Name/ Phone/ E-mail/ Professional Relation
Certifications & Support Skills
Optional Skills & Experience Checklist.: The following section is optional but helps us better understand your background. Please check any areas where you have experience or skills.

Other
If you hold certifications in any of these, feel free to attach them, it’s helpful, but not required.

Cancelof
If you checked other, please provide your other skills below:
Harassment
Jericho’s policy is to prohibit all forms of harassment by our employees. This includes sexual, racial, religious, and other forms of harassment. Have you ever been accused of harassment of any person including, but not limited to, workplace harassment? (Note: a prior accusation is not an automatic bar to employment. The type of accusation and when it occurred will be evaluated by the program before any decision is made.)
If yes, explain.
Criminal Record
Have you ever been convicted of a crime, other than a minor traffic offense? If yes, please describe.(Note: a prior conviction is not an automatic bar to employment. The type of conviction and when it occurred will be evaluated by Jericho before any decision is made.)
If yes, explain.
All statements become part of any future employee personnel files. I authorize investigation of all statements herein,including any checks of criminal records, and release the program and all others from liability in connection with thesame. I understand that, if employed, I will be an at-will employee unless there is an agreement or law which alters thatstatus. Furthermore, I understand that any agreement must be in writing and signed by the designated Jericho official. Ialso understand that misrepresentations or falsifications herein or in other documents completed or submitted by theapplicant will result in dismissal, regardless of the date of discovery by Jericho.
Signature
Should be Empty:

Volunteer Form

Volunteer Preferences

Volunteer/Job Experience

References

Certifications & Support Skills

Harassment

Criminal Record