Volunteer Classroom Aid Application Notice: JavaScript is required for this content. DCLC Volunteer Classroom Aides assist classroom teachers who deliver instruction to adult literacy students. Learn more about this opportunity here: http://delcoliteracy.org/volunteer-classroom-aide. A PA State Criminal Background Check is required as part of the application process. Request a free background check here: https://epatch.state.pa.us. Title(required) Dr. Miss Mr. Mrs. Ms. Mx. First Name(required) Last Name(required) Email(required) Address Line 1(required) Address Line 2 City(required) State(required) Zip Code(required) Phone(required) Personal Information 1. Gender(required) Male Female 2. Ethnicity(required) White / Other Black Hispanic Asian Pacific Islander Native American 3. Date of Birth(required) 4. Have you had a felony or misdemeanor conviction? Yes No Education 1. Highest Educational Degree You Have Earned(required) High School Diploma or Equivalent Associate Degree Bachelor Degree Master Degree Doctorate Degree Other "Other" response to Education Question 1 2. Field of Study for your highest degree 3. School where you earned your highest degree 4. List any professional certifications you hold. Volunteer Information 1. Which Times Work Best For You(required) Morning Classes Evening Classes Please check all that apply. Volunteer Classroom Aides assist DCLC Classroom Teachers at least once a week. Classes are usually held twice a week in either the morning or the evening during the week (not weekends). 2. Tell Us What Interests You about Volunteering.(required) Briefly explain why you are interested in becoming a Volunteer Classroom Aide. Please note that a six-month commitment of continuous volunteering is requested. 3. Media Consent(required) I give DCLC both permission to use my name and my image. I give DCLC permission to use my name by itself and my image with no name attached to it. I give DCLC permission to use my name only. I do NOT give DCLC permission to use my name or image. Please indicate if DCLC may use your name and image in its print and online publicity. Examples of using your name alone include volunteer lists and student success stories. Examples of using your image without your name would be group photos at events. 4. Emergency Contact Name(required) 5. Emergency Contact Phone Number(required) Agreement and Signature(required) By typing my name above and submitting this application, I affirm the facts in it are true and complete, and I agree to comply with DCLC’s Volunteer Classroom Aide duties. I understand that any misrepresentations on this form may result in my dismissal. Date You Completed This Form(required) POLICY OF NONDISCRIMINATION: It is DCLC’s policy to provide equal opportunities without regard to race, color, religion, national origin, gender, sexual preference, age, or disability. Send Δ
