Volunteer Application

The Boys & Girls Clubs of the Corridor appreciates the involvement of volunteers in supporting instructional programs and enriching the learning environment at our club sites. We will make every reasonable effort to provide a safe learning environment for kids working with volunteers. A Volunteer Application is required annually of all volunteers whose primary role is that of working directly with students or assisting staff on a regular basis; supervising/chaperoning students; or acting as an authority figure. Please complete this application if you are interested in serving as an volunteer with The Boys & Girls Clubs of the Corridor. All Volunteer Applications will be checked against the national sex offender database and are subject to a background check.

If you have questions, please contact the volunteer coordinator at STursi@inmyclub.org or 319-363-5766

Personal Information

Legal First Name

Address Line 1

Legal Middle Name

I don't have a middle name

Address Line 2 / Apt # / Building #

Legal Last Name

City

Maiden Name

State/Province/Region

Gender

Postal/Zip Code

Date Of Birth

Phone Number Phone number is required

Affiliation

Please note: An email will be sent to the email address entered to inform you of the status of your application. If you do not have access to email, please enter abrown@inmyclub.org and a district administrator will call you regarding the status.

Please select the schools at which you wish to volunteer

Please select the functions from the list below. (select all that apply)

Please select the organization(s) on behalf of which you are volunteering (if not applicable, select "None")

Please read the disclaimer below and provide your signature

As a volunteer for the Boys & Girls Clubs of the Corridor, I understand that it is my responsibility to treat information about students, staff, and other situations of a professional nature as confidential. I understand I must hold any information about a child's academic progress, behavior, or a club-related incident completely confidential. A breach of confidentiality may result in the termination of my involvement as a volunteer.

Name

Signature

By signing your name you agree to all the above statements. Use the mouse or touch screen to sign.

Thank You

Your volunteer application has been successfully submitted and will be reviewed per our volunteer policy. In the near future, you will be notified as to your volunteer status. If you have any questions, please request to speak with a the volunteer coordinator.