School Year Program Volunteer Interest Form
Name
*
First Name
Last Name
Best Phone Number
*
-
Area Code
Phone Number
Best Email
*
example@example.com
What is the best time of day to reach you?
*
Morning
Afternoon
Evening
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Your Skills and Interests
While Breakthrough of Greater Philadelphia employs our unique students-teaching-students model, we also have opportunities for experienced professionals to support in our programs. Please indicate your current level of education.
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Attending High School
Attending College
Bachelor's Degree
Master's Degree
Doctoral Degree
Please indicate your current level of professional experience.
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Student/No Experience
Pre-Professional
Young Professional
Experienced Professional
Retired Professional
Major or Professional Interest:
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Other interests/talents that you might be willing to share with Breakthrough students:
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Please rate your interest in volunteering with each of the following classes:
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Definitely
Somewhat
Not Much
None
MS Literature and Writing
MS Financial Literacy/Career Exposure
MS Public Speaking
Why are you interested in volunteering with Breakthrough?
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Explain, in your own words, what a commitment to the Breakthrough program means to you.
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Logistics
Please select the campus(es) where you would be willing to work
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Virtual Instruction
Germantown Friends'
Do you have any ongoing Saturday schedule conflicts?
*
Breakthrough cannot be responsible for your transportation. How will you get to and from the program site?
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Legal Stuff
*Please Note: You MUST have clearances in order to work with our students.*
Are You 18 Years of Age or Older? (Note: Volunteers can be younger than 18, but we need to know for classroom/volunteer liability reasons.)
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Yes
No
Do you have your Pennsylvania State Child Abuse Clearance?
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Yes
No
Do you have your Pennsylvania State Criminal History Clearance?
*
Yes
No
Do you have your Pennsylvania FBI Fingerprint Clearance?
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Yes
No
Please upload a copy of your resume in Word or PDF format.
*
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