Volunteer Application

Please complete the application below or click here to download a printable form.

 

Name :
First *     M.I. 
Last *
Address *
City *
State *     Zip Code * 
Phone Number : *
(enter all applicable and select best)
Home
Work
Cell
Preferred number
 Home Work Cell
Email *
 
Emergency Contact :
Name     Phone    
Relationship    
 
Emergency Contact :
Name     Phone    
Relationship    
 
DOB : *   /  /  Sex :      Male Female 
Marital Status : *   Single Married Divorced Separated
Languages Spoken   
Racial/Ethnic Group :

 Asian American African American Hispanic/Latino Pacific Islander
 Native American Caucasian

Other

 
Occupation/Student *   Business/School Name *  
Address         City  
 
Highest Level of Education Completed : *
   Middle School High School Junior College University Graduate School 
 
Do you have any illness, addiction, or disability? *   Yes No 
Explain  
 
Have you ever been convicted of a crime? *   Yes No 
Explain  
 
Are you interested in *       Mentoring Tutoring
If you would like to tutor, would you feel comfortable tutoring in any of the below areas?
 
Language Arts :
   Reading & Comprehension Spelling Writing Research Skills
 
Mathematics :

 Arithmetic Fractions Estimation Measurement & Statistical Principles
 Algebra Geometry Trigonometry Numerical & Graphic Relationship
 Calculus
 
Other :
   Computers  other 
 
How did you hear about Uncommon Good?
 
Please describe prior volunteer experiences, particularly in the areas of mentoring, tutoring, or advocacy :
 
Please list any special interests or hobbies :
 
Please provide three adult references other than family members who we may contact. If you are employed, one reference must be a supervisor.*
Name     Phone    
Relationship     Email     
 
Name     Phone    
Relationship     Email     
 
Name     Phone    
Relationship     Email     
 
I hereby certify that the information provided is true and further understand that any misrepresentation is grounds for removal from participation in Uncommon Good.
 
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Whole Earth Building

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