Minnesota Literacy Council Volunteer Application

Volunteer Preschool Classroom Aide

The following information is used in selecting volunteers, assigning volunteer roles, planning training, and collecting data for evaluation. Any information you provide us will be completely confidential. Qualified applicants are considered for positions regardless of race, color, creed, religion, gender, national origin, sexual orientation, disability or marital status. Thank you for your interest in literacy!

General Information

* Last Name

* First Name

MI

* Street Address

Address Line 2

* City

* State

* Zip Code

* Phone Number

* Email Address

* Employer/School Name:

* Occupation

Are you aware of any volunteer service matching grants provided by your employer?

No

Yes

* How did you learn about this position?

Availability

* Please check the days your are available to volunteer.
Hours are 9:45am - 12:15pm. (2.5 hours)

Monday

Tuesday

Wednesday

Thursday

Experience and Qualifications

* Describe your experience working with children:

* List or describe any special training you have in education and/or teaching English Language Learners (ELLs):

* What interests you about working with preschool ELLs?

* What would you most like to gain from the experience of working with preschool ELLs?

References

To ensure we provide the best possible services to our children, we require each new classroom volunteer to provide references.

Please provide the names of two references we may contact regarding your qualifications for this position. References must not be family members and need to have known you a minimum of 6 months. At least one reference should know you in a professional context (including a work or volunteer supervisor, professor/teacher, religious leader, etc.)

Reference 1

* Name

Title

* Phone

* Email

* How long have you known this individual?

* In what capacity?

Reference 2

* Name

Title

* Phone

* Email

* How long have you known this individual?

* In what capacity?

Health

* Do you have any medical conditions that may require special accommodations to perform the responsibilities as listed?

No

Yes

* Do you have any general health concerns we should be aware of?

No

Yes

* Emergency Contact Name

* Emergency Contact Phone

Demographics

This portion of the application is voluntary and is not used for applicant selection.
The information collected below is used by the Volunteer Services staff to monitor our success at attracting and maintaining a diverse volunteer corps in order to better serve our various communities. It is also reported to the Minnesota LIteracy Council for their annual report and used for the purpose of writing various grants.

Gender

Male

Female

Ethnic/Racial Background

Age

Date of Birth (mm/dd/yyyy)

Do you have a disability?

No

Yes

Highest Education Completed

Employment

Agreement

I declare that the information on this form is true and correct to the best of my knowledge. I understand that any false or misleading information given by me can disqualify me from consideration or result in dismissal at a later time. I understand that completing this application does not guarantee my acceptance as a volunteer, nor does it obligate me to accept a volunteer assignment. I further understand that Minnesota Literacy Council provides no auto insurance coverage for volunteers. I have read and understand the Volunteer Position Description.

* Full Name

* Date (mm/dd/yyyy)

* Indicates Response Required


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