Volunteer Application

Personal Information
*First Name:
*Last Name:
*Street Address:
Apt No:
*City:
*State:
*Zip Code:
Home Phone: Example: 5134754800*
Cell Phone: Example: 5134754800
Work Phone: Example: 5134754800
*Date of Birth:	//
*Email Address:
Employment
*Employment Status:
Job Title/Position:
Company:
Street Address:
Suite No:
City:
State:
Zip Code:
Education
*Indicate highest level of education:
Degree:
Previous Experience/Skills
Please describe your previous experience below
Volunteer Experience:
What special skills, training or interests do you have?
Optional Information
For nondiscrimination reporting purposes only
Gender
Age
Race
Preferences
Please choose either an area to volunteer in or pick a specific school
Location:	West Northwest Downtown East Northeast
Grade Level:
School Preference
Volunteer Positions
CYC has a number of different volunteer opportunities. For more information on the various different positions that are avalible click here.
*Position:
References
Character Reference
*Name:
*Relationship:
Phone Number: Example: 5134754800*
*Street Address:
*City:
*State:
*Zip Code:
Character Reference
*Name:
*Relationship:
Phone Number: Example: 5134754800*
*Street Address:
*City:
*State:
*Zip Code:
For the safety of the students, normal employment verification such as contacting references and police checks will occur.
How did you hear about CYC?
*	Word of mouth TV Radio Internet Newspaper Poster/Flyer Place of Employment CYC Presentation Other
If other:
Group Affiliation
Statement of Commitment
As a volunteer working with Cincinnati Students, I agree to: Attend orientation and training sessions that help me as a volunteer Contact my mentee weekly and see him/her on a regular basic Provide up-to-date copies of my driver's license and car insurance Abide by all school rules, CYC and Board of Education policies By clicking on the submit button you are agreeing to the statement of commitment and authorizing CYC to contact you by either mail, phone and/or email.

	* denotes required field

CYC programs offer great flexibility. From once a week to a one-time involvement, you can use your desire to help.