Volunteer Application Contact Information (Page 2 of 4) Los Angeles Region PreferencePlease select... Region 01: East LA, Boyle Heights, Alhambra, El Monte, Whittier, Covina, West Covina Region 02: South LA, Watts, Compton, Torrance, Gardena, Lawndale, Hawthorne Region 03: Culver City, Santa Monica, Venice, West LA, Westwood, El Segundo, Inglewood Region 04: Long Beach, San Pedro, Norwalk, Carson Region 05: Echo Park, Silverlake, Hollywood, Highland Park, Pasadena Region 07: San Fernando Valley, Glendale, Santa Clarita Region 11: Skid Row Learning Center: After-school Group Tutoring, Downtown Los Angeles Orange County Region PreferencePlease select... Region 09: Northern Orange County: Anaheim, Garden Grove, Fullerton, Huntington Beach Region 10: Southern Orange County: Santa Ana, Costa Mesa, Irvine, Tustin, Orange Ventura/Santa Barbara County (Hide)Please select... Region 08: Ventura County, Santa Barbara Inland Empire (Hide)Please select... Region 06: Corona/Norco, Pomona, Ontario, Upland, Riverside, Chino, Redlands, Rialto Other (Hide)Please select... Region OL 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 I will be the accompanying adult to one or more youth tutors (ages 12-15) NoYes How many children will you be the accompanying adult for?Please select... One Child Two Children Three Children First Child First Name Middle Name/Initial Last Name Email Email address MUST be different then accompanying adult's email address Date of Birth 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 Mobile Phone Talents/Skills e.g. photography, social media expert, music, etc., Motivation to Volunteer What motivated you to volunteer with School on Wheels? Please share anything you would like us to know. x Current School Second Child First Name Middle Name/Initial Last Name Email Email address MUST be different then accompanying adult's email address and first child's email Date of Birth 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 Mobile Phone Talents/Skills e.g. photography, social media expert, music, etc., Motivation to Volunteer What motivated you to volunteer with School on Wheels? Please share anything you would like us to know. x Current School Third Child First Name Middle Name/Initial Last Name Email Email address MUST be different then accompanying adult's email address and other children's emails Date of Birth 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 Mobile Phone Talents/Skills e.g. photography, social media expert, music, etc., Motivation to Volunteer What motivated you to volunteer with School on Wheels? Please share anything you would like us to know. x Current School 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 School on Wheels welcomes volunteers with many types of experience and education. Please check any of the options that apply to you:Tutoring or mentoring children or youth (including formal and informal experience in your community, through an organization, at school, etc)Language Arts (including literacy, reading instruction, learning a second language, storytelling, acting, writing stories, or music)Social and emotional learning (including strength in building relationships, great at listening, lifelong learner, empathetic)Experience or education relating to teaching, psychology, child development, or social workBilingual in English and SpanishDifferent experience/education to bring to School on Wheels 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 Emergency Contact Name Emergency Contact Phone How did you hear about School on Wheels?Please select... College Internet Search Kids First LA Works Other Social Media SpaceX The Shepherd Go Team VolunteerMatch.org Word of Mouth / Friend Work If "Other", please specify: If "College", are you a member of a School on Wheels College Club?: Examples: UCLA, USC, UCI, USCB Employment/Education and Security & Terms (Page 4 of 4) 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 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. I will provide School on Wheels with fingerprint and background check results.Yes Terms of Application and Signature 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 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
