EACS Volunteer Application
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Personal Information
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| Name
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| Prefix
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| First
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| Address
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| Street Address
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| Address Line 2
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| City
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| State / Province / Region
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| Postal / Zip Code
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| Country
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| Email
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| Phone Number
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| Birthdate
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| Ethnicity (optional)
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| Languages Spoken
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| Occupation (optional)
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| How did you hear about EACS?
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Availability
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| I am available (please check all that apply)
| Weekday mornings (9:00am-12:00pm) Weekday afternoons (12:00pm-5:30pm) Weekday evenings (5:30pm-8:30pm) Weekend mornings (9:00am-12:00pm) Weekend afternoons (12:00pm-5:30pm) Weekend evenings (5:30pm-8:30pm)
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Interests
Please indicate which programs you are interested in volunteering for.
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| After School program at New Holly (our office)
| Monday 4:00-6:00 Tuesday 4:00-6:00 Wednesday 4:00-6:00 Thursday 4:00-6:00
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| Tutoring students in their homes
| Times vary
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| Cleveland High School "Sky High Posse" (Leadership Group)
| Thursday 2:30-5:00
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| ESL Talk Time at New Holly
| Monday 10:00am-12:00pm Tuesday 10:00am-12:00pm Wednesday 10:00am-12:00pm Monday 6:30-8:30pm Tuesday 6:30-8:30pm Wednesday 6:30-8:30pm
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| Citizenship Class at New Holly
| Monday 6:30-8:30 Tuesday 10:00am-12:00pm Wednesday 6:30-8:30 Thursday 10:00am-12:00pm
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| Computer Literacy Class at New Holly
| Thursday 6:30-8:00pm Friday 5:30-7:00pm
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| Admin/IT/etc
| Times vary
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Educational Background
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| Previous tutoring/teaching experience
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| Select Highest education achieved
| Some High School High School Graduate Some College Bachelor's Degree Graduate Degree Doctorate Degree
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| School name
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Other Information
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| Have you ever been convicted of a felony?
| Yes No
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| If yes, please explain.
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| List any health conditions, physical or mental.
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References
Please list two people who can act as a reference to your character and/or capacity to serve.
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| Relationship
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Person to Notify in Case of Emergency
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Agreement and Signature
By submitting this application, I affirm that the facts set forth in it are true and complete. I certify that the above information is true and correct. My electronic signature below authorizes East African Community Services (EACS) to obtain conviction records from Washington State Patrol and other states. I understand that the result of this background check will be kept in total confidence.
I agree to release EACS of any and all claims which may arise as a result of any expenses, personal injury, loss or damages incurred while volunteering.
It is our policy to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability.
Thank you for completing this application form and for your interest in volunteering with us!
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| Name (electronic signature)
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| Date
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Image Verification
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EMF HTML Contact Form
EMF HTML Contact Form