| Please provide the following information: |
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| First Name: |
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Place of Employment: |
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| Emergency Contact: |
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| If you are under 18 years old, please provide the following information: |
| Birthdate: |
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School: |
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| Parent(s)/Guardian(s) Name(s): |
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| Parent(s)/Guardian(s) Phone Number(s): |
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I give permission for my son/daughter to volunteer with Read Aloud Delaware. |
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| For what position would you like to volunteer? |
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Reader |
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Parent Educator |
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Clerical |
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Special Events |
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Other
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| Please indicate availability: list in order of preference: |
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| Please indicate date, time and location of training session you will attend: |
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| Can you read in another language? If so, which one(s)? |
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| Special training, skills, or interests: |
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| List past volunteer experiences and other organizations to which you belong: |
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| Would you be interested in working on special events or displays? |
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| Restrictions that might affect your availability for, or type of volunteer service (family, work schedule, transportation, etc.) |
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| How did you hear about Read Aloud Delaware? |
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| Please list two references not related to you (Community, Business, Present, or Past Employer). If you have previously worked with children, paid or volunteer, please list supervisor as a reference. |
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Name: |
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Job Title or relationship: |
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Years known: |
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Name: |
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Years known: |
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| Have you ever been convicted of a crime?
Yes |
No - If yes, please provide explanation below. |
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| In order to provide the safest environment for the children to whom we read, the staff of Read Aloud Delaware will conduct a reference check, a criminal history check, and may conduct an interview. Completion of this application does not guarantee acceptance into the program. |
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I certify that I have been informed and have agreed to these procedure. |
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I certify that the facts contained in this application are true and complete to the best of my knowledge. |
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