Form

T3 Triple Threat Youth Mentors Volunteer Application
Date

- Month - Day Year
I am volunteering as: *

An individual A member of an organization/company
Individual Full Name

First Name Last Name
Organization/Company Name
Organization/Company Contact

First Name Last Name
Contact Phone Number *

- Area Code Phone Number
Contact Phone Ex.
E-mail *
Gender *

Male Female
Age
Current Volunteer Opportunities

Performing Arts Coach (Voice, Dance, Acting, Piano/ Keyboard) Academic Support Marketing Support Fundraising Support Administartion Stage Management, Backstage Support, (make-up, costumes, stage hands)
Interest and Special Skills (check all that apply)

Performing Arts Coach (Voice, Dance, Acting, Piano/ Keyboard) Academic Support Marketing Support Fundraising Support Administartion Stage Management, Backstage Support, (make-up, costumes, stage hands) Health & Self Esteem Sports & Fitness Art & Culture Leadership Development Technology Web/ Graphic Design Photography / Media Arts Events/ Program Coordinations
( If student) Name of high school or collage

Emergency Contacts *

Emergency Contacts

How did you learn about T3 Volunteer opportunities? *
Do you have any experience working with children or volunteering? If so please briefly explain. *
Language(s) Spoken *

English spanish
Occupation
What type of transportation do you use? *
To volunteers interested in instructing classes. The majority of our programs are held on Saturday's 11am-4pm. *

I'm available to teach Dance 11am-12:30pm I'm available to teach Voice 12:30am- 1:30pm I'm available to teach Acting 1:30pm-3:30pm I'm available to teach or assist as needed 11am-3:00pm
Volunteers interested in helping through administrative or other duties. Please indicate your commitment availability. *

1-5 hours a week 5-10 hours a week 10-15 hours a week
Are there any physical limitations or are you under any course of treatment which might limit your ability to preform certain types of work? *

Employment Reference

Character Reference *

Character Reference

Do you have any current misdemeanors? *

No Yes
Convicted of a felony? *

No Yes
I certify that all the answers on the application and any attachments are true and complete to the best of my knowledge. I also certify that I have not withheld any pertinent information. *

By clicking here you agree By clicking here you are adding your signature and date to this agreement
I agree in the course of considering my application, you may inquire to verify information considering my background *

By clicking here you agree By clicking here you are adding your signature and date to this agreement
I agree that T3 Triple Threat Youth Mentors (T3) shall not be responsible for any personal injuries or losses sustained by me while on (T3’s) facilities/ premises or as a result of any agency sponsored activities. *

By clicking here you agree By clicking here you are adding your signature and date to this agreement
All volunteer applicants 18 and older working directly with students must pass a background check through the City of San Diego. *

By clicking here you agree
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