• South Rome Free Tutoring & Mentoring

    Give One Hour. Change a Future. 

  • Volunteer Application

    Please provide your contact and emergency information.
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Availability & Preferences

    Let us know when and how you'd like to volunteer.
  • Preferred Support Area(s)
  • Which days are you available to volunteer?
  • What are your two preferred time slots?
  • Preferred Age Group(s) to Support

  • Background Information

    For the safety of our students, please answer honestly.
  • Have you ever been convicted of a criminal offense?*

  • Background Check Authorization

    Please read and sign to authorize a background check.
  • I authorize South Rome Free Tutoring & Mentoring Program to conduct a background check as necessary for volunteer service. I understand this may include criminal records and reference checks.
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Browse Files
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  • Browse Files
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  • Browse Files
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  • Liability Waiver

    Please read and sign the liability waiver.
  • I release South Rome Free Tutoring & Mentoring Program and its affiliates from any liability for injuries or incidents that may occur while volunteering. I understand that I am participating at my own risk.
  • Do you grant permission for your photo or video to be taken and used for program purposes?*
  • Should be Empty: