PCYDI Volunteer Questionnaire

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Thank you for your interest in Pinckney Community Youth Development Initiative (PCYDI). The PCYDI mission is to create connections to support the positive development, growth, and leadership of youth. We welcome your input! We are reaching out to you because you recently showed interest in our Youth Center, The HUB.

Email *

Full Name *

Email *

Phone Number (no dashes) *

How are you interested in helping out? Please check all that apply. (NOTE: First 4 items listed REQUIRE a background check be completed). *

Volunteer during our open hours

Host an activity at the Hub (crafts, entertainment, learning opportunity, etc)

Help during special events (Spooktacular, Art in the Park, Light Up The Park, etc)

Serve on the board of PCYDI

Provide monetary donations/fundraising - We are currently accepting cash, check, and/or gift cards from local businesses to use as prizes for games and contests.

Donation of necessities such as toilet paper, paper towel, snacks, etc.

Hyping us up on social media

Other:

Required

Please list any further details here on how you are able to help out. *

We are currently looking for volunteers to help Tuesday-Thursday from 2:45-6:00 PM during the school year. Please check all days/times that you can be available (will not ask you to work all of them unless you want to!)

In the summer the hours are 12-5pm broken into two shifts.

**We will need at least two volunteers on duty during all open hours.

Responsibilities will include assisting staff with set up and cleaning of activities and supervision of youth to ensure a safe and welcoming environment.

Tuesdays 2:30 - 4 pm

Tuesdays 4 - 6 pm

Wednesdays 2:30 - 4 pm

Wednesdays 4 - 6 pm

Thursdays 2:30 - 4 pm

Thursdays 4 - 6 pm

I am unable to help out in this way

Required

Do you allow PCYDI to submit a background check on your behalf (required for spending time with children)? *

Yes

No (If selecting No, you cannot volunteer with children or be on the HUB board)

What is your birth date (MM/DD/YYYY)? *Required for Background Check *

Please list any previous Name(s) used. *Required for background check *

What is your Gender? *Required for Background Check *

Male

Female

No Background Check

What is your Nationality? *Required for Background Check *

American Indian or Alaskan Native

Asian or Pacific Islander

Black

White

Unknown/Other

No Background Check

What is your Drivers License or ID Number (Please do not give SS Number)? *Helpful for Background Check

History Questions for Background Check - select all that you can answer "Yes" to.

Provide any further details in the field below for "Further Information" if you checked "Yes" on any of the first three questions.

Have you ever pled guilty, or been convicted of a felony in a state or federal court?

Have you ever pled guilty, or been convicted of a misdemeanor in a state or federal court?

Are you the subject of a current criminal investigation or do you have charges pending against you?

I do not answer "Yes" to any of the above questions.

Required

History Question - Please include any details for the History questions above including date, state, and details.

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