VOLUNTEER REGISTRATION FORM
All information is kept confidential and will not be released without signed consent.
Sign in to Google to save your progress. Learn more
Name *
Date *
MM
/
DD
/
YYYY
Address: *
Email Address: *
Telephone: *
Birthdate: (We need this for statistics.) *
MM
/
DD
/
YYYY
When are you available to work with a learner?  *
Required
Do you have a specific time that you want to tutor? Please add that here if applicable.
Do you prefer a male or female learner? *
What was your last level of education? *
If you studied at College/University, what did you study?
Tell us a little about yourself.  This helps us when matching you with a learner. *
Please list any specific skills you have that you think may assist us in matching you with a learner (ex. languages spoken, previous training, personal experiences, etc.) *
Please tell us why you would like to tutor with the Lacombe Literacy Program.  Let us know if you have any specific objectives or expectations as well. *
Where did you hear about the Literacy Program? *
Please provide us with a personal reference  (friend or family member) below.   Include a full name, phone number, email, relationship to you, and length of time known.   *
Please provide a professional reference (employer, church representative, co-worker, other) here.  Include a full name, phone number, email address, relationship, and length of time known. *
The list below includes expected requirements of our volunteers.  Can you please check off all that you are willing to sign, complete or attend.  We ask you this so that you are aware of some of the requirements of our program. *
Required
Thank you!  Shortly after we receive your form, we will contact you for an informal interview. Please write any additional questions or comments here.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms