Volunteer Application

Make A Difference. Whether you volunteer, mentor, tutor, donate or educate others about the dropout issue, collectively it makes a difference. America must step up and curb the high school dropout crisis. We can all help. Be part of the new education equation!

Please Download and Print the (CORI CHECK FORM) Consent for Background Check
Please make sure you have completed and sign the CORI Form (Bring with you to the Club)
Name:*
Address:*
Date of Birth:*
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Home Phone:
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Cell Phone:*
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Work Phone:
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E-mail:
Currently:*
Name of School, College or University:
Hours you prefer to volunteer: *
Please describe any experience you have had working with young people. Include names of organizations and the dates you were there:
Please describe your interests as a volunteer (i.e., tutor, sports coach, arts & crafts ...):
Please tell us why you would like to volunteer with children:
1: Professional References:
1. Organization:
1. Day time phone #:
1. Job/work you Performed:
2: Professional References:
2. Organization:
2. Day time phone #:
2. Job/work you performed:
3: Professional References:
3. Organization:
3. Day time phone #:
3. Job/work you performed:
A CORI (Consent for Criminal Records Check) and/or a SORI (Sex Offender Registry Check) will be obtained for all employees/prospective employees and volunteers. Do you have any objections for a CORI and a SORI?:*
Recaptcha Word Verification: