Internship / Volunteer Application - Roosevelt Park Ministries

Internship/Volunteer Application

Name(Required)

First Middle Last

Birth Date(Required)

Race(Required)

Gender(Required)

Male

Female

Prefer not to say

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Total hours available per week(Required)

Total hours needed (if applies)

The days and hours of our ESL program are: Tues & Thurs 9:30-11:00 AM or Tues & Thurs 6:00-7:30 PM. NOTE: In general, to volunteer as an ESL Instructor you need to be available both Tuesdays and Thursdays either in the morning or the afternoon for the entire semester (12 weeks each for the Spring and Fall sessions, 8 weeks for the Summer session).

Days/Times Available to Teach ESL(Required)

Available to teach twice per week Tues&Thurs 9:30am-11:00am

Available to teach twice per week Tues&Thurs 6:00pm-7:30pm.

Please check all that apply.

On occasion we have opportunities to teach ESL one evening per week for a two-hour block from either 5 pm - 7 pm, or 5:30 pm - 7:30 pm. Please check the box below if you are interested in teaching ESL one evening per week.

Teach ESL One Night Per Week

I am interested in teaching ESL one night per week.

Days/Times available for other volunteer work

Mondays

Tuesdays

Wednesdays

Thursdays

Note: RPM is closed on Fridays.

Start date available(Required)

End date (if known)

Interest area(Required)

Past experience(Required)

Professional References

Name(Required)

First Last

Phone(Required)

Relationship(Required)

Name(Required)

First Last

Phone(Required)

Relationship(Required)

Name(Required)

First Last

Phone(Required)

Relationship(Required)

What is your reason for seeking to volunteer here?(Required)

What special skills, talents, gifts or personality traits would you bring to this ministry?(Required)

Emergency Contact Name(Required)

First Last

Relationship to you(Required)

Emergency Contact Phone(Required)

Background checks are required for all RPM volunteers.(Required)

I authorize Roosevelt Park Ministries to run my background check as part of this volunteer application.