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National After-School All-Stars

Volunteer

Volunteer Today!


After-School All-Stars Application For Volunteer Services
* required information
 Please Answer All Questions
General Information

First Name:*

Last Name:*
Middle Initial:
Email:
Address Line 1:*
Address Line 2:
City:*
State:*
ZIP/Postal Code:*
Phone:*
Cell Phone:
Are you 18 years or older?:* Yes
No
Birth Date:*(mm/dd/yyyy)
Alternate Phone:
Social Security Number:
Reason for Volunteering (check all that apply): Personal satisfaction
To meet school requirements
To meet community service requirements
Other
Hours Required:
Availability:*
Why are you applying to volunteer for the After-School All-Stars?:*
When are you available to volunteer? (check all that apply): Anytime
Weekends
Weekdays
Specific Days/Hours of Availability:*
Which school level/program are you interested in voluteering at? (check all that apply): Elementary Site
Intermediate Site (4-6)
Middle School Site
Intern
Judo/Dance S.J.S.U.
Middle School Sports
MIRACLES (MACSA or Burnett)Volunteer/Mentor
Job-related skills, training, and other qualifications you may have from previous employment or other experiences:
Are you currently First Aid certified?: Yes
No
Are you currently CPR certified?: Yes
No
CPR Expiration Date:(mm/dd/yyyy)
First Aid Expiration Date:(mm/dd/yyyy)
Employment Information

Employer 1 Name:

Address:
Telephone:
Supervisor Name:
Duties:
Dates Employed:
Job Title:
Employer 2 Name:
Address:
Telephone:
Duties:
Dates Employed:
Job Title:
Supervisor Name:
Personal Reference (please include relationship to applicant and phone number):
Personal Reference (please include relationship to applicant and phone number):
Personal Reference (please include relationship to applicant and phone number):
Have you ever been convicted of a criminal offense (felony or misdemeanor)?: Yes
No
If yes, please explain (you may omit traffic offenses, any convictions which have been sealed, expunged, 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):
I have read and agree with the clause regarding denial of employment due to criminal offense:* Yes
No
I have read and agree with the Volunteer Code of Conduct:* Yes
No
I have read and agree with the Certification of Applicant clause:* Yes
No