Name* First Middle Last School Attended*Year*Email* Phone*Box #Are you on Work Study?*YesNoDo you have a car?*YesNoAre you certified to drive the college vans?*YesNo(doesn’t apply to all colleges)Will you be available to work all year?*YesNo(fall and spring semester)Are you available in January?*YesNoHow many hours per week would you like to work?*What is your major in school?*Are you looking for a volunteer or work-study job placement?*Describe your schedule. Will you be available from 2-6:30PM at least one afternoon per week (Monday – Thursday) so that you could tutor at a school?*Describe your past experiences working with youth.*If you were to help out in an enrichment activity, what type of activity would you want to teach?*(examples include robotics, painting or storytelling)What are your career goals/interests?*If possible we will try to create an experience that will provide you with work experiences that are tailored to meet your specific goals.