I AM APPLYING TO VOLUNTEER WITH CORONA-NORCO UNITED WAY: I am applying to volunteer for the following programs: * Paths to Success Program Family Support Services Financial Independence Training Homework Club Children Wellness Program Type of Application I am applying as a / an: * Volunteer (I plan to volunteer for a minimum of 6 months) Volunteer for less than six months (fill in time below. Intern (Fill in Information below) Number of Weeks Volunteeering If you are volunteering for less than six months, fill this in with the number of weeks you are available. Type of degree working towards (if applying as an intern) Aa Ba-Bs Ma-Ms Personal Information First Name * Last Name * Date of Birth * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022 Home Address * City * State * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Postal Code * Contact Methods Email * Cell Phone * Work Phone Home Phone Preferred Contact Method * E-Mail Cell Phone Home Phone Work Phone How did you hear about United Way? * United way website Staff/volunteers School Social media Other Optional - Check All That Apply Asian/Pacific Islander Native American Black/African/African American White/Caucasian Latina/o Multi Racial/Ethnic Other If 'Other', please explain Are you currently enrolled in school? * Yes No If 'Yes', which school? Which languages, other than English, do you speak? Have you been convicted of an offense, other than a minor traffic violation, as an adult? * Yes No If 'Yes', please elaborate. See instructions below. Please state the nature of the offense(s), when and where convicted and current status of the offense. Emergency Contact Information Emergency Contact Name * Emergency Contact Phone * Why do you want to volunteer for united way? * What skills and experience will you bring to our agency as a volunteer? * Have you or are you currently volunteering for another organization? if yes, which one and what is your current role? * What would you like to gain from volunteering at united way? * Please share some of your ideas about why adults may not obtain a high school diploma? * What additional challenges might a (person of color, undocumented, non-english speaking, lgbtq, or etc.) have in reaching out for help? * Signature I certify that all statements on this application are true to the best of my knowledge. I give paths to success program permission to run a background check. * I agree CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.