Pathways Summer Volunteer Application

Name*

First Middle Last

Address*

Street Address City State ZIP

Phone*

Email*

Birth Date*

Work Status*

Current or previous place of employment*

Work Experience*

Administrative
Marketing
Nursing
Teaching
Retail
Finance
Other

Other:*

How did you hear about our program?*

Have you ever committed, been convicted of, pled guilty to, or pled nolo contendere to a felony or misdemeanor?*

No
Yes

Please explain*

Personal References*

Please list 2 references. Use the plus button to add your second reference. Do not include relatives. Please see secondary reference form.

First Name	Last Name	Phone	Email

What do you hope to gain from your volunteer experience?*

Pathways is our after-school youth mentoring program. Many of the below activities take place during this program. Which are you most interested in?*

Other:*

As a Pathways Volunteer, it is required that you have at least one year experience working with youth.

List any previous experience working with youth, including length, ages of youth, organization and location:*

Have you ever been refused participation in or asked to leave any other youth program? If so, please explain.*

List any special training, degrees, certifications (CPR /First Aid), special skills or foreign languages:*

Alamo Community Group has several Learning Center locations. Please check your preferred location:*

Babcock North - 11800 Spring Shadow San Antonio, TX 78249
Bentley Drive - 8004 Bentley Dr. San Antonio, TX 78218
Castleridge - 8021 W. Military Dr. San Antonio, TX 78227
Cypress Cove - 6100 NW Loop 410 San Antonio, TX 78238
Springfield Manor - 4827 Explorer Dr. Kirby, TX 78219
Thompson Place - 1727 Thompson Place San Antonio, TX 78226
Western Hills - 500 Tomar San Antonio, TX 78227
Woodland Ridge - 7026 Wurzbach Rd San Antonio, TX 78240

Please indicate the days and times you are available to volunteer.*

If an emergency were to occur while on an ACG community, who should we notify:

Name*

First Last

Relationship:*

Address*

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

Phone*

As an Alamo Community Group volunteer, I:*

Agree to attend a mandatory volunteer orientation
Agree to comply with all rules and regulations of Alamo Community Group and the Volunteer Program
Understand that I may be dismissed from my duties for willful wrongdoing or negligence and/or performing duties outside of my service guidelines
Agree to call the Learning Center Resident Coordinator as soon as possible when I have scheduling changes
Agree to commit to at least 66 volunteer hours during the 2019 summer

(please check all above boxes for consideration)

Confidentiality:*

It is the policy of Alamo Community Group that all personal information pertaining to a Learning Center participant is confidential and is protected from unauthorized viewing, discussion, and disclosure. Any unauthorized viewing, discussion, or disclosure will provide grounds for immediate dismissal. Whenever it is questionable as to what information is confidential, it is your responsibility to discuss the matter with the Learning Center Resident Coordinator before any breach of confidentiality occurs.

I acknowledge and have read the statments above and agree to abide by the expectations of ACG's Volunteer Program and Alamo Community Group.

Do you certify that all information set forth in this application submitted to Alamo Community Group is true, correct, and complete, without any willful omissions? Do you understand that if this application is false in any way you will be dismissed without notice regardless of when the false information is discovered.*

Yes

PATHWAYS SUMMER VOLUNTEER APPLICATION