TEEN Volunteer Registration Volunteer Information Name * First Name Last Name Birth Date * MM DD YYYY Religious Affiliation/ Congregation Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Home Number Cell Number * Email Address * How did you hear about us? School Attending * Grade * Principals Name * First Name Last Name School's Phone Number * Name of Reference * Please provide a non family relation First Name Last Name Phone # of Reference * (###) ### #### Relation to Reference * Parent Information Father's Name * First Name Last Name Father's Cell * Father's Email * Occupation/Workplace Mother's Name * First Name Last Name Mother's Cell * Mother's Email * Occupation/Workplace Program Information FRIENDS AT HOME Check all the days you are available to volunteer: Sunday Monday Tuesday Wednesday Thursday Friday Any days you can not volunteer: Sunday Monday Tuesday Wednesday Thursday Friday I would like to volunteer with my friend First Name Last Name Please select your first choice of time that works for a visit: Hour Minute Second AM PM Please select your 2nd choice of time that works for a visit: Hour Minute Second AM PM How far are you willing to drive? 10 minutes 15 minutes 20 minutes 25 minutes 30 minutes Please check the box for which programs you can attend and be a part of Bowling Buddies 9/7 10/12 11/16 12/7 1/4 2/1 3/8 4/12 6/14 Tennis 9/28 10/26 11/30 1/25 2/22 3/22 4/26 5/24 6/28 Buddies & Movement 9/28 10/26 11/30 12/21 1/25 2/22 3/22 4/26 5/24 6/28 Boxing with Buddies 9/21 10/19 11/23 1/18 2/15 3/15 4/19 5/17 6/21 Shabbat Dinner 9/5 12/5 2/27 4/24 Holiday 10/12 Sukkot Party 12/16 Chanukah Party 3/3 Purim Party 5/22 Shavous Ice Cream Party Winter Camp 12/22 12/23 12/24 12/25 I have a talent I would like to share. How would you prefer to be contacted ? Email Phone Text Message Social Media Medical Information Emergency contact name (other than parent) First Name Last Name Emergency Contact Phone Relationship to you: Additional Medical Information Please list any allergies or medical needs we should be aware of: Volunteer Agreement * There will be an orientation seminar on August 24, which all past and new volunteers will be required to attend before beginning to volunteer. The orientation will go over various programs, opportunities, and more. At this time volunteers can address any concerns and can then choose the program that is a good fit for them. Any information pertaining to the child or family will be confidential. Community service forms will ONLY be issued for volunteering that is recorded on the FC app. When you commit to being a volunteer, we will be relying on you as a buddy for one of the children. In the event that you are unable to volunteer, you will need to notify the Friendship Circle at least 3 days in advance and will try to find a substitute. By checking this box you are aware and agree to all of the above. Signature * First Name Last Name Date * MM DD YYYY Thank you for submitting your New Volunteer Application. A staff member will be in touch with you.
