Literacy Volunteers of Wayne County, Inc.

Volunteer Common Application Form

Requirements: Applicant must have a high school diploma, GED, External Diploma, or the equivalent, or be a senior in high school. Applicant must be able to transport self to library, church, or other public place. Applicant must be willing to work with or represent preliterate, semiliterate, or limited English proficient adults in Wayne County or some subgroup thereof, or a local community or community interest.

Background Information:

Name:

Address:

Phone Number:

E-Mail address (optional):

Years of Education: 12 16 16+

Related Experience(s) (includes Sunday school, etc.):

Position Information:

I would like to volunteer as a:

Tutor Trainer Committee Member Board Director Events Volunteer Tech Vol.

Availability: Weekdays (hours) Weekends (hours)

I am not available:

Eligibility Information:

Special Skills:

Special Considerations:

 

References (please include names, addresses, and phone numbers):

 

Have you ever been convicted of a felony? yes no

By submitting this form, I am affirming that all of the information contained above is true and accurate to the best of my knowledge. I understand that all of this information is confidential, and that Literacy Volunteers of Wayne County will not release it to anyone without my permission. I further understand that Literacy Volunteers has a responsibility to protect and effectively serve their students.