EmailMe Form - TeenWorks Mentor/Volunteer Application

EmailMeForm

Volunteer Position(s) you are interested in: *
Mentor
Mentor Trainer
Mentee Workshop Presenter
Volunteer/Recruiter
Other (specify below)
If "Other," indicate here
Today's Date *
MM / DD / YYYY
Name *
First Last
Date of Birth *
Age 21 or older? *
Yes
No
Physical Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code
Mailing address (if different from physical address)
Email *

Confirm Email
Phone *
### - ### - ####
Marital Status *
Married
Single
Divorced
Others in your household (name & relationship):
How long have you lived in the Tuolumne/Calaveras area? (Years/months?) *
Present employer *
Supervisor's Name *
First Last
Employment Supervisor's Phone *
### - ### - ####
Supervisor's Email (if any)
Employer's Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code
What is your highest level of education? *
References
Please provide the name and contact information for three references
Reference 1 Name *
First Last
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Phone *
### - ### - ####
Email
Reference 2 Name *
First Last
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Phone *
### - ### - ####
Email
Reference 3 Name *
First Last
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Phone *
### - ### - ####
Email
Emergency Contacts
Please list two people we can contact in case of emergency.
Emergency Contact Name 1 *
First Last
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code
Phone *
### - ### - ####
Emergency Contact Name 2 *
First Last
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code
Phone *
### - ### - ####
Please describe any previous experience with mentoring/volunteering or working with youth. *
What interests you the most about being a mentor or volunteer for the TeenWorks mentoring program? *
What skills can/would you contribute to the program? How will they enhance your ability to be a youth mentor or help the organization achieve its mission, vision, and objectives? *
Please provide any insight you might have on how you handled a difficult situation. *
What are your special interests? What do yo like doing in your free time? *
Are you willing to make at least a 12-month commitment with your mentee or volunteer position: *
Yes
No
Do you have a car? *
Yes
No
Have you ever been arrested for criminal activity? *
Yes
No
If yes, explain in comment box below.
Comment on arrest:
Please indicate times you are busy and unable to devote tmie to your mentee. *

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

This will help us in determining which mentee will be best suited for you.
SPIRITUAL INFORMATION
What church are you currenty attending? *
Do you regularly attend worship services at your church? *
Weekly
Monthly
Occasionally
I do not regularly attend worship services.
How long have you been affiliated with your current church? *
What ministries are you involved in? *
Please write a short paragraph explaining your testimony/spiritual journey. Discuss your present relationship with God. *
Mentor applicants: What do you feel you have to offer a youngperson in the area of your own spiritual life and relationship with God?

Other Volunteers: Why/how do you feel led to volunteer with TeenWorks? *
Signature (use mouse or finger to sign)
Clear
By signing, you attest to the truthfulness of all information listed on this application. You agree to allow our program staff to confirm all information listed and to submit to required criminal record checks.
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Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

References

Emergency Contacts

SPIRITUAL INFORMATION