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Volunteer Academic Mentor Application

Volunteer Academic Mentor Application

Contact Information

Salutation

First Name

Last Name

Suffix

Email

Confirm Email

Street Address and Unit Number

City

State

ZIP

Home Phone

Cell Phone

If you do not have a cell phone, please input your preferred number here.

Work Phone

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Phone

How did you learn about Boston Partners in Education?

Please Specify

Background

Date of Birth

Month

Day

Year

Gender

Race or Ethnicity you most identify with:

Parent or Guardian of BPS Student?

YesNo

At which school(s)?

Did you attend a BPS school?

YesNo

Which school(s)?

Hobbies and Interests:

Based on your personal and professional skill set, please select any other ways you would be interested in supporting Boston Partners in Education

Not ApplicableMarketingFundraisingVolunteer RecruitmentTechnical SkillsOther

Please provide any relevant details

Work Status

Employer

Job Title

School

Are you applying to Power Lunch through your employer?

YesNo

Are you applying as part of a volunteer group or organization?

YesNo

Please specify

Do you speak any languages other than English?

NoneCape Verdean CreoleChineseHaitian CreolePortugueseSomaliSpanishVietnameseOther

Please Specify

Do you have a physical condition that should be considered in selecting the right school assignment for you?

YesNo

Please Describe

Volunteering History & Goals

What are your motivations for volunteering?

Please list any volunteer experience you have, specifically any experience with youth/students

In what ways do you anticipate being able to help students both academically and socially?

Volunteer Interests

Please select all volunteer settings you may be interested in:

One-to-One Academic MentoringSmall Group Academic MentoringWhole Class Support (K-2)

Please select the grade level(s) you are interested in working with:

PreschoolElementary School Grades K-2Elementary School Grades 3-5Middle School Grades 6-8High School Grades 9-12

Please select all subjects you are interested in working in:

MathEnglish Language ArtsScienceArt

Which science subject(s) do you feel comfortable working in?

PhysicsBiologyChemistryEarth Science

What level(s) of math are you comfortable working in?

Algebra IAlgebra IIGeometryPrecalculusCalculusStatisticsNone of the above

Additional Comments:

Availability for Volunteering

Are you able to commit to volunteering in a classroom for one hour per week, sometime between 7:30 AM and 4:00 PM, Monday through Friday?

YesNo

If you are unable to commit to volunteering during those days and times, we do offer some limited evening and weekend options for academic mentoring.

Please select all the neighborhoods you would be interested in volunteering in:

Allston/Brighton	Back Bay	Charlestown
Chinatown	Dorchester	East Boston
Fenway/Kenmore	Hyde Park	Jamaica Plain
Mattapan	Mission Hill	North End
Roslindale	Roxbury	South Boston
South End	West Roxbury	No Preference

Primary mode of transit:

Convenient MBTA Line(s):

Red Line	Orange Line
Green Line	Blue Line
Silver Line	Commuter Rail

Convenient Bus Line(s)

Contact Information

VOLUNTEER

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