DRMI Geeks & Gramps Youth Volunteer Application

DRMI Geeks & Gramps Program Youth Volunteer Application Form
Under the corporate umbrella of Divine Revelations Ministries Inc. (DRMI), the Geeks & Gramps (Grandparents) Program is an intergeneration technology-focused program that helps to bridge generational gaps between youth 8-18 and older adults. The program is designed to bridge the digital divide by helping older adults to overcome feelings of isolation and feel more confident with technology and digital platforms. In group and mentoring sessions, youth learn innovative technology such as virtual reality and robotics, professional development, and life skills that can be used for a lifetime, and additionally, they are transformed through volunteerism, while helping older adults. We are excited about your interest in volunteering with our program. Please complete the form below to apply.
Parental involvement is the key to a successful youth-focused program. We ask parents to at least attend the first Meet & Greet informational meeting to meet the outstanding and dedicated individuals who will be working with your child in the program. Meeting dates will be communicated prior to the first class workshop.
Your Name*

First NameLast Name
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*

Area CodePhone Number
Emergency Contacts*
Will you need transportation to/from program locations? Please note a separate parental consent form is required.

YesNo
Do you need any other accommodation services in order to perform your volunteer duties?*

YesNo
Please enter what type of accommodation services do you need.*
Your Grade in School*
Your School Name and City*
Your Birth Date*

MonthDayYear
Date
How did you find this volunteering program?*

Add times that you are available in the "From and To" fields. Leave unavailable days blank.*

	From	To
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Why do you want to be a volunteer in the DRMI Geeks & Gramps Program?*
Which of the program activities are you most interested in?

Helping seniors learn how to use technologyLearning about new and innovative technology, like virtual reality, robotics or gamingEarning a Certificate in Microsoft OfficeField trips to visit Science, Technology, Engineering, Mathematics (STEM) programsVolunteering in the communityI am interested in being mentored by an older adultOther
Please tell us your other volunteering experiences. In none, type "none"*
What do you like to do when not in school?*
DRMI captures demographic information for funder reporting. With what race/ethnicity do you identify?

Prefer not to answerAfrican American/BlackAmerican Indian or Alaska NativeHispanic or LatinoMulti-racial (2 or more races)Native Hawaiian or Other Pacific IslanderWhiteOther
With what gender do you identify?

FemaleMaleNon-binary (self-identify as another gender)Prefer not to answerOther
Photographic & Volunteer Release (parental approval is required): DRMI is a grassroots 501c3 charitable organization with a mission of helping all people to live more enriching lives. We accomplish our mission by providing life skills and professional development programs that connect youth and older adults, and other vulnerable members of the community. DRMI strives to empower all individuals through our life-skills programs and classes, coaching, and mentoring opportunities.

As the parent/guardian of this youth applicant, I hereby acknowledge that the information given above is accurate and I give permission to Divine Revelations Ministries, Inc. (DRMI) the sponsor of the DRMI Geeks & Gramps Program to use my child's photographs and/or video recordings that are taken by staff in order to use for marketing/advertising of the program as applicable under Florida copyright and child protection laws. I understand that if my child is accepted as a volunteer, any false statements, omissions, or other misrepresentations made on this application may result in immediate dismissal.
Volunteer Candidate Signature or Initials*

Clear
Parent of Candidate Signature*

Clear
Date

MonthDayYear
Date
Should be Empty:

DRMI Geeks & Gramps Program Youth Volunteer Application Form