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  volunteer volunteer application

Volunteer Information Form

Complete the form below, then print it and either mail or fax it to ReWA at:

Refugee Women's Alliance
Attn. Shaun Rose
4008 Martin Luther King Jr. Way, South
Seattle, WA 98108

Fax: 206-721-0282 

Staff use only:  
Interview scheduled  
Volunteer placed  
Training scheduled  
Background check done  
Volunteer record filled in  
Name
Address
City, State, Zip WA, 
Date
Home Phone
Work Phone
E-mail Address

Which of the following volunteer opportunities interests you?

ESL Classroom Assistant (working with adults)
ESL Small Group Teacher (working with adults)
Childcare Assistant (working with preschoolers)
Bilingual Assistant (working with adults or children)
Teaching Assistant (working with school-aged children)
Office Support
Computer Support
Fundraising
Other (please specify)
 

Why do you want to volunteer at ReWA?

Please describe any teaching/tutoring experience you have had?

What other skills or experiences do you possess that might be useful as a ReWA volunteer?

Languages spoken or studied .

Availability:

Days/times during the week

Monday Times
Tuesday Times
Wednesday Times
Thursday Times
Friday Times

Number of hours per week		  

Minimum time commitment in number of months		  

Have you had any ESL training?  When and where?

Have you ever been convicted of a crime? Explain.

References:  Please list two references (Prefer at least one to be employment/education/volunteer-related.)

Name Title Phone Number

Volunteer Profile

Gender   Female Male

Education Completed

Grade 9-11 High School. Diploma GED
Some College 2-year Degree 4-year Degree
Graduate Degree        

Employment Status

Student  Employed 
Unemployed, Seeking Work Not Seeking Work
Profession/Occupation

Referral Source

Court/Probation Employer/School
Library Newspaper
Poster/Sign/Flyer TV/ Radio
WA State Literacy Hotline Other Literacy Program
Word-of-mouth Other (Please describe)
     

Peace Corps. (or other volunteer corps.)

Peace Corps. experience
Experience in any other volunteer corps.
  Name of other volunteer corps.
  Position 
  Dates of service Start: End:

 

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Main Office: 4008 Martin Luther King Jr Way S, Seattle, WA 98108