Peer Mentor Volunteer Form
Age / Grade
Volunteer phone number:
Emergency Information (Parent / Guardian, Phone number, email):
Volunteer- Allergies/ Medical issues:
Areas of Interest:
Skills / Background:
List information if Social Motion Skills needs to provide Service Hours verification:
Which service group or school are you signing up with?
For example: ACL, NCL, School Name or Club
I agree to become a SoMo Volunteer in peer group socializing activities. I agree to be positive role model and an active group participant. If I cannot attend my scheduled volunteer time, I will contact Social Motion Skills as soon as possible.
Should be Empty: