Volunteer Enrollment Form

All information will be treated confidentially and will not be shared.

*For the School-Based or After-School Mentoring Programs: Please list 2 persons who have known you for at least a year, specifically:

1) Spouse/significant other (if not applicable, then a family member)

2) Work, School or Personal Reference

*For the Community-Based Program: List 4 persons who have known you for at least a year, specifically:

1 ) Your current/ past employer or co-worker

2 )A friend who has known you for at least 2 years

3) Your spouse/ significant other (if not applicable then a family member who is familiar with your home environment)

4) Someone who has observed you interacting with children (someone other than your parent)

Note name, city, phone number, email address, and relationship to you.

Example:
John Doe Asheville 828-771-9088 johndoe@gmail.com Employer

Please list any arrests, convictions, and traffic violations. Please provide charge as well as disposition/result.