Volunteer Application
Thank you for becoming a volunteer with Whiz Kids Tutoring. This application needs to be completed and your background check cleared before any interaction with children can begin. The information in this application will be kept confidential as this is a secure website.

* - Required field

MAP OF SITES


Preference Information
I am interested in
Volunteer Position
If Other
Preference for Tutoring(Check all that apply)
Special Request(site choice, placed with friend, family, near work, etc)
Contact Information
Please provide your full legal name
* First Name
Middle Name
* Last Name
* Home Address 1
Home Address 2
* Home City
* Home State
* Home Zip Code
* Home Phone
* Cell Phone
Work Phone
Work Phone Ext.
* Email Address
How did you hear about Whiz Kids
Employer
Occupation
Demographic Information
* Date of Birth
* Gender
Ethnicity
Marital Status
Spouse First Name
Spouse Last Name
Driver Information
Tutor may be required to transport their student to and from the site (1-2 miles)
MINOR
* Driver's License Number
Auto Insurance Provider
Policy Number
Expiration Date
Home Church
Foreign Language
Do you own a tablet device (iPad, Kindle, etc.) that you can use during tutoring?
Background Information
* Have you lived in Colorado more than 2 years?
YesNo
* If less than two years, please state previous county and state
For purposes of the certification below, a "conviction" means any conviction by a jury or court, any payment of a fine, a plea of "no contest"/ nolo contendere, imposition of a "deferred" or "suspended" sentence, or forfeiture of any bail, bond or other security. "Misdemeanor" includes any drug or alcohol-related misdemeanor driving offense, but does not include any other misdemeanor traffic offense or traffic violation.
* Under penalty of perjury, I hereby certify:
No, I have never been convicted of committing any felony or misdemeanor
Yes, I have been convicted of the following felony(ies) or misdeanor(s)
ConvictionsPlease include date, city/county/state and charges for each conviction.
* Please check one:
No, I have never been dismissed or resigned from employment following an allegation of unlawful behavior involving a child.
Yes, I have been dismissed or resigned from employment following an allegation of unlawful behavior involving a child.
Please explain
Reference 1
* Reference 1 Name
* Phone
* How long have you known this person?
Emergency Contact Information
* Name
* Phone
* Emergency Contact Relationship

As a volunteer with Whiz Kids, you are asked to agree to the following guidelines:

  1. Make a commitment for at least ONE school-year (approximately 24 weeks)
  2. Read and utilize the resources in your Tutor Manual, and attend an Orientation and Training
  3. Be dedicated and dependable in maintaining a weekly relationship with your student at your site
  4. To provide transportation for your student to and from the tutoring site as necessary
  5. To understand and accept that Whiz Kids is a faith-based program and materials presented during Club Time will reflect this foundation
  6. Whiz Kids may use your photograph and/or video material in its promotional materials
  7. Understand that any activity with your Whiz Kids’ student outside of regular tutoring time is your own responsibility and not under the jurisdiction of the Whiz Kids Tutoring Program. I also understand that Whiz Kids recommends the following procedures 1). obtain parental permission on a signed permission slip for each occasion and, 2). Always go with another adult.
  8. Authorize Whiz Kids Tutoring to obtain a consumer (criminal history) report on you. This consumer report may contain negative information about your background. This authorization, in original or copy form shall be valid for this and any future consumer report that may be requested by Whiz Kids Tutoring. 

 

* The information in this application is correct to the best of my knowledge. I agree to the aforementioned guidelines. I authorize any references listed in this application to give you any information that they may have regarding my character and fitness for working with urban youth. I release all such references from any liability for furnishing such evaluation to you, provided they do so in good faith without malice. I authorize Whiz Kids Tutoring to conduct inquiries with appropriate Colorado agencies and references to confirm my eligibility to participate as a volunteer. I understand that Whiz Kids Tutoring operates in areas with statistically higher crime rates and I accept the risk inherent in working in these areas.