Application and Waiver

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*Please use a personal EMAIL address and not one linked to your university/school.

Email *

Under 18 Requires Parent/Guardian's Consent *

By checking this box, I understand that if I’m under 18, my parent or guardian needs to fill out this form for me.

Required

First and Last Name *

Your Gender *

Male

Female

Phone Number (Include Area Code) *

Birthdate (* Please note: most volunteer roles require participants to be at least a 9th grade student.) *

YYYY

Address (Street Number, Name and Apt#) *

City, State, Zip *

How did you hear about Kim's Open Door? *

Emergency Contact... Their Full Name, Relationship, Phone Number *

Availability *

International Summer Academy (ISA), June 15th- July 23rd, Monday-Thursday

Tuesdays 1pm - 4pm (Junior High & High School Refugee Tutoring & ESOL Program)

Wednesdays 5pm - 8pm (Wednesday Elementary Program)

Thursdays 1pm - 4pm (Junior High & High School Refugee Tutoring & ESOL Program)

Food Pantry (Off Campus) — Ages 18+ only, unless accompanied by a parent volunteer. 2nd Saturdays 9am-11am

Required

Summarize special skills and qualifications you have acquired from employment or previous volunteer work, including performing arts, hobbies, or sports.
*

Kim's Open Door sponsors faith based and non-faith based programs. What is your religious affiliation and why?
*

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