CATHOLIC CHARITIES HOGAR HISPANO

Volunteer Application

 

I.  CONTACT INFORMATION

 

Name:__________________________________________________   Email:__________________________________

            Mr./Mrs./Ms.                First                                     Last

 

Address:__________________________________________________________________________________

                                Street                                                                                       City, State                                                                                Zip                          

 

Telephone:_________________________      _________________________   Birthdate:________________

                               Home                                                                 Work/Cellular                                                                          Day/Month/Year

 

Emergency Contact:_________________________________________________________________________

                                                       Name                                       Evening Phone                                         Daytime Phone                                 Relationship

 

 

II.  BACKGROUND AND SKILLS

Please list any academic organizations, professional organizations, service organizations, clubs, faith communities, churches, synagogues, or mosques to which you belong:


 


 


 


 


Please list any agencies and organizations for whom you have volunteered (past/present):

 


 


 


What are your professional and academic talents?

 


 


 


Please describe your level of computer literacy and any proficiency in foreign languages:

 


 


 


What do you hope to gain by volunteering with Hogar Hispano?

 


 


 


 

 

III.  PROFESSIONAL AND PERSONAL REFERENCES 

 

Current Employer or Academic Institution:____________________________________________________

                                                                                                                School/Agency/Business/Organization                                                      City

 

Job Title/Course of Study:___________________________________________________________________

 

1.  Current Supervisor/Academic Advisor:

 


  Mr./Mrs./Ms.          First Name                              Last Name                               Telephone                                               Email

 

2.  Professional/Academic Reference:        

 


  Mr./Mrs./Ms.          First Name                              Last Name                               Telephone                                               Email                       Relationship

 

3.  Personal Reference:        

 


  Mr./Mrs./Ms.          First Name                              Last Name                               Telephone                                               Email                       Relationship

 

III.  INTERESTS AND AVAILABILITY

Please indicate how you would like to serve immigrants in our community:

English as a Second Language Site (ESL) Coordinator         Teen Tutor                         Office and Administrative Assistant

ESL Teacher                                                   Technology Aide           Job Development Assistant

Teaching Assistant                                                     Substitute Teacher         Social Services/Information & Referral  

Citizenship Workshop Volunteer                                        Legal Assistant                I have a special skill to share:

                                                                                                                                                                   __________________________________

 

Please indicate when and where you are available to volunteer:

   Alexandria                 Arlington Dale City          Dumfries          Fairfax          Burke

   Falls Church            Manassas  Reston              Sterling             Vienna          Woodbridge

                       

IV.  SIGNATURE

   In signing and completing this volunteer application, I:

                · authorize Hogar Hispano staff to contact the references I have provided above in regards to this volunteer position.

                · understand that Hogar Hispano’s staff and students expect site coordinators and teachers to serve for one academic year.

                · agree to attend a minimum of 12 hours of teacher training.               

· certify that the information provided on this application is true and accurate.

               

                                                                                                                ______________________________________________    ________________

                                                                                                                    Signature                                                                                 Date

 

 

Thank you for your interest in serving others with Catholic Charities Hogar Hispano!

 

Please print this form, complete it, and mail it to:

Amy White ♦ ESL Program Coordinator ♦ Catholic Charities Hogar Hispano

6201 Leesburg Pike ♦ Falls Church, Virginia 22044 ♦ 703-534-9805 x238 ♦ Fax: 703-534-9809

www.ccda.net ♦ awhite@ccda.net