2012 College Life & Activities Volunteer Form
Questions marked with an asterisk (*) are mandatory.
1
* Name (First and Last):
2

* Gender

3
* Email Address:
4

* Phone Number

5

* Is the number above your:

Home
Business
Cell
6

* Please provide an address (you may use home or business, whichever is most convenient for you)

Company Name (if applicable)
Street Address
Suite/Apartment #
City
State
Zip
7

* Where do you work (or attend school)?

8

* What best describes the industry in which you work or are studying to work?

9

* Where did you attend college?

10

* What year did you graduate college?

11

Which College Activity Table would you like to host (you will be with one to two other volunteers)? 

You can choose two additional options by answering Questions 12 and 13.

12

Any additional College Activity that you would be interested in speaking about?

13

Any additional College Activity that you would be interested in speaking about?

14

* How did you hear about CPY?

Current CPY/former mentor
Friend or colleague (not affiliated with CPY)
Social event
Other volunteering organization
Online
Other, please specify
15

* If you have previously volunteered with CPY, how would you describe your past experience?

Outstanding
Above average
Average
Below average
I have not volunteered with CPY
If you listed Below average, please specify
16

* I hereby certify that I have never been involved in any criminal activity, felony or misdemeanor. I further certify that all information provided on this application is true and complete. I understand that falsification or significant omissions of any information may be considered justification for non-acceptance or dismissal if discovered at a later date. 

 

If selected as a mentor, I understand that CPY will conduct a background check prior to my work with students.


Pressing the "Yes" button below shall serve as an electronic signature for the purposes of this volunteer application.