Volunteer Tutor Application

Please complete this application form if you are interested in becoming a Community Education Partnerships volunteer tutor. Once you complete the form, click the continue button at the bottom.

Personal Information

If you are a minor tutor or the adult guardian supporting a minor tutor, please include the their name when asked.

First name:

Last name:

Middle name:

Street 1:

Street 2:

City:

State:

* Zip: *

Home phone:

OK to call me here

Work phone:

OK to call me here

Cell phone:

OK to call me here

Email address:

Date of birth:

Gender:

Minor or Supporting a Minor:

Emergency Contact Name:

Emergency Contact Phone:

Minor or Parent/Guardian Name:

Please answer the following questions: 1. How did you hear about Community Education Partnerships? 2. What motivated you to volunteer with Community Education Partnerships? 3. What experience do you have working with students and/or underserved populations?

Education and Interests

Employment Information

Current Employer or School:

Position:

Years at Company/School:

Street 1:

Street 2:

City:

State:

Zip:

References

Please provide two references who have known you for at least two years and who are not related to you. Please let your references know to expect a call or an email.

1

2

First Name:

Last name:

Work phone:

Cell phone:

Email address:

Availability

Please let us know when you are available to tutor. Most tutoring takes place after 3pm Monday-Friday or during the day on weekends.

Background and Security Information

To safeguard the children we serve, Community Education Partnerships screens all volunteer applicants. All information is confidential and will not be shared.

PLEASE ANSWER "YES" OR "NO"

Have you ever been convicted of, or pleaded guilty or nolo contendere (no contest) to, a crime that has not been expunged, sealed, erased or pardoned? (A conviction includes any plea, verdict or other finding of guilt regardless of whether sentence is imposed by the court.)

Background and Security Information

IF you answered "YES" to the previous question, please state the nature of each offense and the date, city, state and disposition:

Background and Security Information

PLEASE ANSWER "YES" OR "NO"

If accepted for volunteer services, can you present evidence of your legal right to reside in the United States during the time you expect to be providing services for Community Education Partnerships?

Terms of Application

PLEASE ANSWER "YES" OR "NO"

If I am accepted to perform volunteer services, I agree to comply with all rules, regulations, policies and procedures of Community Education Partnerships as they now exist and may be modified from time to time at the sole discretion of Community Education Partnerships.

Terms of Application

PLEASE ANSWER "YES" OR "NO"

I understand that, if selected, I will perform academic tutoring to selected students without receiving any monetary compensation or other financial benefits for my services.

Terms of Application

PLEASE ANSWER "YES" OR "NO"

I understand that if I am selected to perform volunteer services for Community Education Partnerships, it may terminate my assignment at any time, with or without cause, and with or without notice.

Signature

Please type your full name in the box.

Under the Electronic Signatures in Global and National Commerce Act (E-Sign), the information you submitted on this application is legally binding in the same manner as are hard copy documents executed by hand signature.

Terms of Application and Signature

I certify that the facts contained in this application, or any other document used for selection purposes as well as any other verbal or written statements made by me during the selection process, are true and complete to the best of my knowledge. Additionally, I certify that I have read each of the foregoing statements and that I understand and agree to adhere to each of them.

I Agree