Cincinnati Youth Collaborative | Volunteer Signup Form

Thank you for your interest in supporting Cincinnati’s vulnerable youth.

There are always high school and elementary students waiting for someone like you to prepare them for college. Many of our mentoring relationships have begun in elementary school and continued long past high school. If you’d like to become a mentor of a student in this age range, we can match you more promptly.

Personal Information
*First Name:
*Last Name:
*Street Address:
Apt No:
*City:
*State:
*Zip Code:
Home Phone: Example: 5133635200*
Cell Phone: Example: 5133635200
Work Phone: Example: 5133635200
*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
What previous Volunteer Experiences do you have?
*What motivates you to be a volunteer?
*What special skills, training, hobbies, or interests do you have?
Tell us about a positive role model in your life, and how they helped you.
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:
Describe your ideal mentee's personality:
Do you have a preference on your mentee's ethnicity?
Do you have a specific student in mind whom you’d like to mentor?
School Preference
*Are you intested in Co-Mentoring?
*Would you be willing to mentor a court involved youth, and if so, what level of experience do you have?
*Would you be willing to mentor a youth experiencing homelessness, and if so, what level of experience do you have?
*Would you be willing to mentor a youth with mental health needs, and if so, what level of experience do you have?
Group Affiliation
Volunteer Positions
CYC has a number of different volunteer opportunities. For more information on the various different positions that are available click here.
*Position:
References
Character Reference
*Name:
*Relationship:
*Email Address:
Phone Number: Example: 5133635200*
Character Reference
*Name:
*Relationship:
*Email Address:
Phone Number: Example: 5133635200*
Character Reference
*Name:
*Relationship:
*Email Address:
Phone Number: Example: 5133635200*
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 Be the Change CLC Website Other
If other:
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 basis (Mentors Only) Provide up-to-date copies of my driver's license and car insurance (Mentors Only) 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 add you to their mailing list and contact you by either mail, phone and/or email. The form make take up to a minute to be processed. Please only click the Submit button once.

	* denotes required field

Volunteer Signup Form

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