Volunteer Role Model Application
Thanks so much for applying and wanting to be a role model to one of our kids.

The time commitment is different for all of our kids, so we can arrange anything from once a week to once a month.

Consistency is one of the most lacking qualities in the kids' lives, so one of the most important commitments as a CCChampions role model is making sure that you can be there each and every time. We ask you to be honest with yourself and with us about what you can and cannot commit to.

Steps to becoming approved:

1. Fill out this volunteer application

2. Send documentation of clearances/vaccinations to Volunteering@CCChampions.com (if you do not have them yet, email us and we will help you get them)

3. Volunteer Coordinator reaches out to your references

4. 30 min. interview with Volunteer Coordinator (we will reach out to find a time)

First Name *
Your answer
Last Name *
Your answer
Email *
Your answer
Address *
Your answer
How you found out about us *
Your answer
Gender *
Birthday
MM
/
DD
/
YYYY
Phone Number *
Your answer
How many months would you be willing to commit to being a CCChampions volunteer? *
Your answer
I am comfortable volunteering...
I am comfortable volunteering...
Do you have access to a car? *
I am a... *
Have you lived outside of Pennsylvania in the last ten years? *
If you are going to school in Pennsylvania and are from another state, please select "Yes"
If you indicated "Yes" above, please describe.
which states and when?
Your answer
Are you a U.S. Citizen? *
Have you ever pleaded guilty, been convicted of, accepted ARD or similar program, or pleaded no contest other than a summary offense? *
Note: we are required to share this information with the family prior to pairing you with a child.
If you indicated "Yes" above, please describe.
Your answer
Which day(s) would you prefer to volunteer? *
Required
My current availability for the days checked above is... *
Your answer
Do you want to partner with one of your friends/coworkers? If so, who?
Our role models often volunteer in pairs. You can apply with a friend/coworker or we can match you with another one of our role models! Both people should fill out an application.
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