Apply to Volunteer

Name*

First Last

Address

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

Home Phone

Cell Phone

Work Phone

May we call you at work?

Yes
No

Email*

Employment

Employment Status

Employed
Retired
Homemaker

Employer (previous, if retired)

Position

Employer Address

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

Education

Last year of school completed?

Jr. High (6th-8th)
High School (9th-12th)
College
Grad School

Degrees (please specify)

Other Education or Training

Volunteering

Please specify your area of interest as a volunteer.

(Press the Ctrl key to select more than one.)

If other is selected, please specify your area of interest.

Why are you interested in working as a volunteer for SBLC?

How did you learn about our program*

If interested in working with adult learners, do you have any tutoring/teaching experience

Yes
No

Please describe:

Are you willing to learn to teach...

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Please describe any previous volunteer experience.

Which days of the week would you prefer to volunteer?*

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

What time(s) of day are you available as a volunteer?*

Morning
Afternoon
Evening
Anytime

Other Experience and Interests

Do you speak any languages other than English?

Yes
No

Which languages?

Do you have any special skills or training?

Yes
No

Please describe:

References

List one professional and one other reference (non-relative) of individuals who have known you for more than one year.

Reference 1

First Name Last Name

Reference 1 Relationship

Reference 1 Phone

Reference 2

First Name Last Name

Reference 2 Relationship

Reference 2 Phone

Emergency Contact

Name

First Last

Phone

SBLC Tutor Agreement

As a tutor for SBLC, I agree to:

Tutor my learner two hours weekly with a minimum of eight hours per month.
Commit at least one year of tutoring to the learner with whom I am matched.
Fill out tutoring hours and progress log and submit to Learner Support Services Specialist monthly. (Reporting tutoring hours monthly allows us to chart the learner's progress and enables SBLC to maintain funding for the program.)
Attend tutor support meetings and ongoing training offered quarterly when I am available.
Maintain contact with Learner Support Services Specialist monthly to inform of changes, achievements, or problems. Notify the Learner Support Services Specialist if my learner and I have changed our meeting times, location or stopped meeting for any reason.
Contact my learner ahead of time if I cannot make it to a session, and inform the Learner Support Specialist of rescheduled meeting time and location.
Keep information about my tutor/learner relationship confidential.

As a volunteer tutor, I expect to:

Receive prompt responses to any questions or concerns regarding my involvement.
Be able to use my volunteer experience as a reference for future job employment.
To request a transfer of assignment or a review of my involvement if ever I feel it is necessary.
To receive the weekly volunteer emails, wherein I will be notified of any changes and upcoming meetings, along with other organizational news.

I realize that SBLC needs this information to track the progress of each learner, as well as to assess the Center and any need for improvement. I realize that I am making a serious commitment and will do my best to fulfill these terms.

Background Consent

I understand that typing my name below is legally the same as signing in person.*

Yes
No

Please Type Your Name Below*

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