Volunteer Application - LearningWorks

Name*

First Middle Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Home Telephone*

Work Telephone

Other Telephone

Email

How did you learn about volunteer opportunities at LearningWorks?*

Agency webpage
Agency brochure

Are you volunteering as part of a requirement?*

Yes
No

Please check whichever applies*

service learning project
academic credit
court/restorative justice
workfare
other

How many hours must you complete, and by when?

Why do you want to volunteer with LearningWorks?*

What is your availability to volunteer? (Please list days and times)*

How long can you volunteer?*

less than 3 months
3 to 6 months
6 to 12 months

In what community(s) would you prefer to be assigned?*

Portland
South Portland
Westbrook
Biddeford
Waterboro

Please describe your computer skills*

What languages do you speak?*

Are you currently volunteering for another organization?*

Yes
No

If yes, where and for how long?

What type of volunteer opportunities interest you? (check all that apply)*

Tutor an adult immigrant or refugee learning to read or write in English
Assist or teach an English language class for adult immigrants and refugees
Mentor an adult immigrant or refugee who is integrating into the community
Mentor an alternative education student transitioning into adulthood
Tutor an elementary school student in English literacy
Help students struggling in elementary school-day programs to catch up with their peers
Assist teachers in an afterschool program serving elementary school students
Assist teachers in a summer program serving elementary school students (seasonal)
Support the agency’s operations with behind-the-scenes administrative support

What is your educational background? (please list last level obtained and area of study)*

What is your job or career background? (please attach resume if you have one)*

Upload your resume

Please describe other volunteer experiences or skills you want us to know about

Please list two non-family member references we may contact

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email

Relationship*

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email

Relationship*

Do you have a close personal relationship to a LearningWorks employee or client?*

Yes
No

If yes, with whom?

I understand that to be considered as a volunteer at LearningWorks, I must complete and sign the attached Background Investigation Information Sheet.*

I understand that if I am a volunteer with LearningWorks, there is protection for volunteers from civil liability during the course of appropriate service under the Federal Volunteer Protection Act of 1997.*

I certify that the information I have provided in this form is true, accurate, and complete to the best of my knowledge.*

Signature*

Date*

MM

DD

YYYY