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Application Form

This document is an application for Dream Mentoring Program volunteers. It collects contact information, languages spoken, education and work details, volunteering experience, experience working with children, reasons for interest in mentoring, and requires confirmation that no criminal offenses, mental or physical health issues would prevent volunteering. The application asks for references and a signature to confirm the truth of the information provided.

Uploaded by

Dipshikha Majumder
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© © All Rights Reserved
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
17 views

Application Form

This document is an application for Dream Mentoring Program volunteers. It collects contact information, languages spoken, education and work details, volunteering experience, experience working with children, reasons for interest in mentoring, and requires confirmation that no criminal offenses, mental or physical health issues would prevent volunteering. The application asks for references and a signature to confirm the truth of the information provided.

Uploaded by

Dipshikha Majumder
Copyright
© © All Rights Reserved
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Dream Mentoring Program

Full Name:

Gender : M ( ) F( )

Address:

Contact No : Email Id ( Provide 2):

Local Languages Known Other Than English ( Can speak fluently)

Kannada ( ) Tamil ( ) Telugu ( )

Any other Languages:

Course pursuing :

Name of College :

Type of Photo ID Proof Attached :

Volunteering Experience:

 Volunteered with Dream A Dream Programs Yes ( ) No ( )

o Have you attended an orientation/induction about Dream A Dream?

Yes ( ) No ( )

o If yes, provide details about volunteering role:

 Volunteered with Other NGOs/Non-Profits

Yes ( ) No ( )

o If yes, provide details about volunteering roles:-

Do have any experience working with children?


Yes ( ) No ( )

If yes, provide details:-

Why would you like to volunteer as a mentor in this program?

Please provide any 1 reference

Family Member In case of outstation( Local


Guardian/Friend)
Name: Name:
Occupation: Contact Number:
Contact Number: Email:
Email:

VOLUNTEER MENTOR APPLICATION

Can you acknowledge and confirm the following statements are true (Tick those true):-

 I have not been involved in cases of criminal offences. ( )


 I am not being treated for any mental health illness. ( )
 I have not had any recent personal tragedy ( )
 I do not suffer from any severe physical/health illness that may hamper me from
volunteering. ( )

I hereby acknowledge and confirm that the above information is true and
complete.

Signature:

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