1.About you

Name

Address

Address 2

City

State

Zip Code

Email Address

Phone Number

2.Employment

Place of Employment

Occupation

Work Address (City Only)

3.Do you have foreign language skills?

Yes

No

4.If Yes, what language?

5.In general, why do you want to be a mentor with the PAWS program?  Are you looking to just give back to your community?  Do you want to work with a specific population?  Tell us anything that may help us pair you with the right child. 

6.Mentoring sessions will occur at Okmulgee Primary from 4:00pm to 5:00pm. Monday - Thursday and will be with first, second, and third graders.  Mentors are asked to attend one time per week. Which day(s) of the week do you expect that you might be available?  

(Our PAWS liaison will confirm this time with you at a later date, this just aids our planning.)

Mondays at 4:30pm

Tuesdays at 4:30pm

Wednesdays at 4:30pm

Thursdays at 4:30pm

Other (please specify)

7.All volunteers at Okmulgee Public Schools and the YMCA, must have a background check.  This includes the YMCA's independent background check, OSBI's criminal offender, sex offender, and violent offender checks, and fingerprinting.  You consent is needed. Our PAWS liaison will contact directly for personal information (birthday, SSN) to initiate these checks (These will be paid by OEF.)

Yes, I consent

No, I do not consent.