Online Volunteer Application - UECDC | Urban Erie Community Development Corporation

Your Name *

First

Last

Permanent Address *

Permanent City *

Permanent State *

Permanent ZIP *

Mailing Address (if different then Permanent address)

Cell Phone: *

Home Phone: *

Email *

Date of Birth *

Best phone number to contact you? *

Cell Phone
Home Phone

Best way to contact you? *

Call
Text

Sex

Male
Female
Other

U.S. Citizen? *

Yes
No

Marital Status *

Best time of day to contact you *

Morning 8am-12pm
Afternoon 12pm - 5pm
Evening 5pm-8pm
Anytime

Are you over 18 years old? *

Yes
No

Is this required for community service? *

Yes
No

Will you receive school credit for volunteering? *

Yes
No

Emergency Contact Name *

First

Last

Relationship to Emergency Contact *

Emergency Contact Work Phone: *

Emergency Contact Cell Phone: *

Emergency Contact Home Phone: *

Did you go to high school in Erie? *

Yes
No

If yes, which high school did you attend?

If yes, did you graduate? If yes, what year did you graduate? If no, what was the last grade you completed?

Are you currently in college?

Yes
No

We ask college volunteers to commit to one afternoon a week for a semester.

If yes, which college are you enrolled?

If you are in college what is your major?

We ask college volunteers to commit to one or more afternoons a week for a semester. Please check the afternoon (after school program hours are 2:30 pm - 5:30 pm) that you would like to commit to.

Have you lived in Pennsylvania for at least ten (10) years? *

Yes
No

Skills and Experience: Please list skills you have that may be relevant.

Please list prior and current employment or volunteer experiences:

Do you have experience working with children?

Yes
No

Please indicate which activities you are most interested in. *

Tutoring (please list the subjects below)
Reading to children or helping children read
Arts and crafts activities
Helping children use the computer
Other ( please complete the what you are interested in volunteering to do below)

If you checked tutoring, please list subjects you could tutor.

If you checked Other, please state how you are interested in volunteering.

Single Line Text

Program goals are to create leaders, help children develop to their fullest potential, and to deliver programming in a positive environment of safety, support, and care. As a volunteer you agree to help further the programs goals, show up when expected, communicate with the staff when you are unable to, and behave in a professional manner. *

Yes
No

PHOTO RELEASE**: I hereby grant to Urban Erie Community Development Corporation (UECDC) permission to interview me and/or use my likeness in photograph(s)/video in any and all of its publications and in any and all other media, whether now known or hereafter existing, controlled by UECDC, in perpetuity, and for other use by UECDC. I will make no monetary or other claim against UECDC for the use of the interview and/or the photograph(s)/video. *

Yes
No