BACKGROUND INFORMATION

Last Name First Name Middle Initial
Local Address
City State Zip
SS# Phone Number
Non-School Email School Email Sex
School Classification DOB
Emergency Contact Relationship
Emergency Phone #
How did you hear about Raising Expectations?
Do you have any volunteer experience? If yes, please explain
Child Age prefer to work with Do you need transportation?
Days Available: Monday Tuesday Wednesday Thursday Friday
                             Saturday Sunday
Are you a convicted felon?    
In your opinion, what qualities should a volunteer possess?
Special Skills:
EDUCATIONAL BACKGROUND
High School Date Graduation Date
College Degree Major
Graduation Year
Recent Work Experience
Recent Work Supervisor Phone #
Recent Work Address
Reference 1 Name Phone #
Reference 1 Address
Reference 2 Name Phone #
Reference 2 Address