Gompers Preparatory Academy Imagineer Application 2018-2019
Thank you for your interest in volunteering at Gompers Preparatory Academy! The information below will be used to assist in placing you in an assignment best suited to your background and interests, and the needs of the school. If you have any questions please contact Alexandra Alvarenga at partnershipschools@ucsd.edu.
Timestamp *
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Full Name (First, Middle, Last) *
Your answer
Nickname/Preferred name
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Emergency Contact Name and Phone Number *
Your answer
Current Home Address (San Diego, CA)
(Use format: Street, City, Zip Code)
Your answer
Date of Birth
(use format: XX/XX/XXXX)
Your answer
Gender *
Through which of the following programs are you serving at Gompers Preparatory Academy *
How did you find out about volunteer opportunities at Gompers? *
Graduation Year *
Your answer
Major/Minor *
Your answer
Relevant Experiences
In a brief manner, please list any relevant experiences you have in working with younger students (elementary, middle, or high school). Note: Prior experience is not required to participate, this section will give us a better idea of where to place you.
Your answer
Daily Availability for Volunteering *
Please enter your daily availability with the understanding that the GPA bell schedule goes from 7:30 am-12:45 pm on Monday, and 7:30 am-3:00 pm Tuesday through Friday. Assignments will be based on this availability information and will not be changed, so please make sure to be as accurate as possible. Should your availability change after you enter this information, please contact partnershipschools@ucsd.edu.
Your answer
Which are you applying for? *
Note: Classroom tutoring positions require a commitment of at least 4 hours per week. Non-classroom positions require a commitment of 4-10 hours per week.
Required
For CLASSROOM POSITIONS ONLY: Check off your preferred grade level(s)
While we do our best to align your classroom placement with your areas of interest and expertise, these determinations are also based on the needs of the school.
For CLASSROOM POSITIONS ONLY: Check off your preferred subject(s)
We will try to align your classroom placement to your areas of interest and expertise. However, GPA does place an emphasis on the schools math curriculum and your placement may be determined based on this need.
For CLASSROOM POSITIONS ONLY: If volunteering for middle school on Mondays, what periods would you like to volunteer
* periods 3 & 4 are switched
For CLASSROOM POSITIONS ONLY: If volunteering for middle school any day Tuesday-Friday, what periods would you like to volunteer
For CLASSROOM POSITIONS ONLY: If volunteering for high school on Mondays, what periodswould you like to volunteer
* periods 3 & 4 are switched
For CLASSROOM POSITIONS ONLY: If volunteering for high school any day Tuesday-Friday, what periods would you like to volunteer
For CLASSROOM POSITIONS ONLY: When would you like to depart GPA
*If you have to depart GPA a few minutes before class ends it is okay, you will just need to communicate with the teacher you will be assigned to
Do you have any additional information you would like us to know while preparing your schedule? If different from above please list the days of the week you will volunteer, high school or middle school, periods, and time.
Your answer
For NON-CLASSROOM POSITIONS ONLY: Check off your top three positions
While we do our best to align your placement with your areas of interest and expertise, these determinations are also based on the needs of the school. We typically receive many applications for few positions outside of classroom roles. IN THE EVENT THAT YOU ARE NOT SELECTED FOR A NON-CLASSROOM POSITION, YOU HAVE THE OPTION (AND WE WELCOME YOU!) TO SERVE IN A CLASSROOM ROLE INSTEAD.
For NON-CLASSROOM POSITIONS ONLY: In addition to submitting this Volunteer Application, we require a resume to be emailed to Brenda Capilla at bcapilla@gomperscharter.org and Fatima Jacobo at fjacobo@gomperscharter.org
Please use the subject line: Resume - Gompers Preparatory Academy, Your Full Name (Note: If you are applying for an Internship Position, please be sure that you will be able to commit to the position if you are selected)
Please share any other comments that can help us place you in the proper role at Gompers Preparatory Academy
While we do our best to align your classroom placement with your areas of interest and expertise, these determinations are also based on the needs of the school. If you are applying for a NON-CLASSROOM POSITION, this is a good space in which to identify your top three choices IN ORDER OF PREFERENCE, and specify your preferred classroom role in the event you are not selected for one of the non-classroom options.
Your answer
Do you have any criminal charges pending against you? *
Have you ever been convicted of a felony? *
Have you ever been convicted of a sex or drug related offense? *
Are you required to register as a sex offender (Code 290.95)? *
For security reasons, a criminal history check might be made and references may be required. You may not volunteer if you have been convicted of a felony or are required to register as a sex offender under California Law. Volunteer assignments are subject to school's needs and may be terminated if service isunsatisfactory or dress code is not followed (see Volunteer Handbook - to be provided at the Volunteer Orientation). By providing my electronic signature below, I declare under penalty of perjury, that all the information on this application is true and correct. *
Your answer
Boundaries Policy *
Please check each box below to indicate you have read and understand the unacceptable behaviors for volunteer/student interaction. This list, and any subsequent list(s), is not meant to be all-inclusive, but rather illustrative of the types of behavior addressed by this policy. You may find the policy in your Volunteer Handbook or by going to this link- https://drive.google.com/file/d/0B2LNM09yVn_3Q2FwZ2kzRE14bFJIeXFISFdaLVp2M1B5aUow/view?usp=sharing
Required
By providing my electronic signature below, I declare under penalty of perjury, that I have read and agree to follow the Volunteer/Student Interaction Policy. *
See previous question for the details of this policy
Your answer
Volunteer Code of Conduct *
Please check each box below to indicate you have read and agree to abide by the following code of volunteer conduct:
Required
TB Test Requirement
All public schools require volunteers to submit negative TB test results to keep on file. Gompers Preparatory Academy must have a copy of the results from a negative TB test done within 60 days of beginning on campus. You can have a TB test done at the UCSD Student Health Center. (Free for students with UC SHIP or RAFT. Approximately $30 for students without either. For more information: http://studenthealth.ucsd.edu/costs.shtml)
Transportation Needs *
While we cannot provide nor coordinate transportation to and from Gompers Preparatory Academy, We hope your responses to this question will assist participants in independently identifying and connecting with other volunteers who may be able to support with their transportation needs.
By signing my name electronically here, I declare under penalty of perjury, that all the information on this application is true and correct. i also declare that I have read and agree to follow the "GPA Volunteer Code of Conduct and GPA Volunteer and Student Interaction Policy." Furthermore, I agree to abide by the GPA Volunteer Handbook that I will receive at my orientation. *
Your answer
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