Volunteer Application Save my progress and resume later | Resume a previously saved form Resume Later In order to be able to resume this form later, please enter your email and choose a password. Your Email: A Password: Confirm Password: Password must contain the following: 12 Characters 1 Uppercase letter 1 Lowercase letter 1 Number 1 Special character Contact Information (Page 2 of 4) Tutoring Region PreferencePlease select... Region 1- East LA, Boyle Heights, South Pasadena, East Pasadena, El Monte, Whittier, Covina, West Covina, Baldwin Park, Monterey Park, Montebello, Pico Rivera Region 2- South LA, Watts, Hawthorne Region 3- Culver City, Santa Monica, Venice, West LA, Westwood, El Segundo, Inglewood, Koreatown, Mid-City, Miracle Mile, Pico-Robertson Region 4- Long Beach, San Pedro, Norwalk, Carson, Compton, Lawndale, Torrance, Gardena Region 5- Echo Park, Silverlake, Hollywood, Highland Park, Pasadena Region 7- San Fernando Valley, Glendale, Santa Clarita Region 8- Ventura and Santa Barbara Counties Region 9- North Orange County: Anaheim, Garden Grove, Fullerton, Huntington Beach Region 10- South Organge County: Santa Ana, Costa Mesa, Irvine, Tustin, Orange Region 11- Skid Row Learning Center Region OL- Online tutoring only and/or living in the following areas: Inland Empire, Antelope Valley, San Diego County Street Address City State Zip Code Address TypePlease select... Home Work Other Mobile Phone Home Phone Work Phone Preferred PhonePlease select... Mobile Home Work Race/EthnicityPlease select... American Indian or Alaska Native Asian Black or African American Hispanic/Latino Native Hawaiian or Other Pacific Islander White Two or more of the above Prefer not to answer GenderPlease select... Female Male Non-binary Prefer not to say Pronouns Please select... He His Him She Her Hers They Them TheirPlease select ALL that apply by using the CTRL key to highlight multiple rows Employment & Education Employment StatusPlease select... Employed Self-employed Retired Not currently employed Currently in school Current Employer Title My employer matches volunteer hours: Education Education LevelPlease select... Currently In High School GED High School Graduate Some College Associate's Degree Bachelor's Degree Master's Degree Doctorate or Professional Degree Other Education Level Other Volunteer Details (Page 3 of 4) Conversational Languages (In addition to English) Please select... Spanish American Sign Language (ASL) Arabic Armenian Cantonese Farsi French German Hebrew Hindi Italian Japanese Korean Mandarin Other Portuguese Punjabi Russian Tagalog Urdu VietnameseHold CTRL/Command to select more than one Other Languages (if "Other" is selected above) Motivation to Volunteer What motivated you to volunteer with School on Wheels? Please share anything you would like us to know. x Do you have experience working with neurodiverse students (such as those students with autism spectrum disorder, ADHD, learning disabilities) and/or students who have an Individualized Education Plan (IEP)? (This is not required experience to tutor)Please select... Yes No Grade Preferences No PreferenceK-23-56-8High SchoolSelect grades (one or more) you prefer to tutor. AvailabilityPlease give us a rough idea of what times you are available to tutor. We understand that school and work schedules do change, but this will be starting off point as we work to pair you with a good student match. Availability During weekday business hours Weekday Evenings (after 5:30 PM) Weekends How did you hear about School on Wheels?Please select... College Internet Search LA Works Other Project Sankofa Social Media Idealist.org Word of Mouth / Friend Work Community Event If "Other", please specify: Name of Person Who Referred You: Event: Security & Terms (Page 4 of 4) Emergency Contact Please provide an emergency contact. This individual will only be contacted in the case that there is an emergency at a tutoring site. Emergency Contact Name Emergency Contact Phone Background Security Information To safeguard the children we serve, School on Wheels asks that all volunteer applicants submit to a Livescan fingerprint background check. All information is confidential and will not be shared. Please note that volunteers are responsible for the LiveScan fee ($40-50) I will provide School on Wheels with fingerprint and background check results.Yes References School on Wheels thoroughly screens all applicants. Please provide two professional and/or personal references. We will contact your references and ask them to complete a short survey about your capacity to volunteer with children and sensitive populations. Reference #1 Name Reference #1 Email Reference #2 Name Reference #2 Email Terms of Application and Signature I understand that the minimum commitment to School on Wheels is one year of volunteer service to ensure consistency and stability for students experiencing homelessness. I agree to keep School on Wheels updated if my availability changes.Yes If I am accepted to perform volunteer services, I agree to comply with all rules, regulations, policies and procedures of School on Wheels as they now exist and may be modified from time to time at the sole discretion of School on Wheels.Yes Policies and Procedures I understand that, if selected, I will perform academic tutoring to selected students without receiving any monetary compensation or other financial benefits for my services. I understand that if I am selected to perform volunteer services for School on Wheels, it may terminate my assignment at any time, with or without cause, and with or without notice.Yes Please type your full name Under the Electronic Signatures in Global and National Commerce Act (E-Sign), the information you submitted on this application is legally binding in the same manner as are hard copy documents executed by hand signature. DL ApplicantYes I would like to receive the School on Wheels monthly newsletter to read about stories from the field, student success stories, ways to get involved, and more!Yes I would like to receive School on Wheels text message action alerts.Yes Save my progress and resume later | Resume a previously saved form
