2011-12 Project Cornerstone/YMCA Volunteer Application

 

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1. Contact Information

Contact Information   First name
Last name
Address
City
State
ZIP code
Preferred telephone number (with area code)
Email address

2. Does your employer offer grants or matching donations?

Does your employer offer grants or matching donations?   Yes No

If you answered yes, might you please provide the name of your employer.

3. Does your spouse's/partner's employer offer grants or matching donations?

Does your spouse's/partner's employer offer grants or matching donations?   Yes No

If you answered yes, might you please provide the name of their employer.

4. Area(s) of Interest: Please check as many as apply. (For example, if you plan to volunteer as an ABC volunteer in an elementary school and a book club facilitator at a middle school, please check both boxes.)

Area(s) of Interest: Please check as many as apply. (For example, if you plan to volunteer as an ABC volunteer in an elementary school and a book club facilitator at a middle school, please check both boxes.)   Preschool Program ABC - Asset Building Champions Los Dichos (Spanish language) Book club facilitator (middle schools) Take IT Personally facilitator (formerly Taking Asset Building Personally) Chinese Cultural Program Indian Cultural Program Event planning General office assistance Translation

If you selected "translation," which languages?

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5. If you are applying to volunteer for ABC, Los Dichos, or Middle School Book Clubs, please provide the name of your school. If you are applying for another kind of volunteer work, please let us know the location you'd like to volunteer, or let us know that you do not have a preference.

I would prefer to volunteer at this school or location:

If you are applying to volunteer for ABC, Los Dichos, or Middle School Book Clubs, please provide the name of your school. If you are applying for another kind of volunteer work, please let us know the location you'd like to volunteer, or let us know that you do not have a preference. I would prefer to volunteer at this school or location:

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6. I volunteer with more than one program, my second program and school is:

I volunteer with more than one program, my second program and school is:

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7. Have you ever been convicted of a criminal offense? You may omit traffic offenses; any convictions that have been sealed, expunged, or statutorily eradicated; convictions more than two years old for marijuana-related offenses for personal use; and misdemeanors for which probation was completed and the case judicially dismissed.

Have you ever been convicted of a criminal offense? You may omit traffic offenses; any convictions that have been sealed, expunged, or statutorily eradicated; convictions more than two years old for marijuana-related offenses for personal use; and misdemeanors for which probation was completed and the case judicially dismissed.   Yes No

If "yes," please explain: