Volunteer Academic Mentor Application 2022-2023 If you have previously applied or volunteered with us and would like to volunteer this year, please do not complete this form again. Contact [email protected] for more information about getting involved again this year. Thank you! Volunteer Commitment Do you prefer to volunteer in-person at a school or virtually through a video call?In-person at a schoolOnline through a video callIn person or online For in-person volunteering: Are you able to commit to volunteering for one hour per week, sometime between 7:30 AM and 4:00 PM, Monday through Friday, or limited hours on Saturday?For virtual volunteering: Are you able to commit to volunteering for two hours per week, sometime between 4:00 PM and 8:00 PM, Monday through Friday, or limited hours on the weekend?YesNo Commitment AgreementI acknowledge this is a minimum one-hour weekly commitment for the duration of the school year Requirements if you plan to participate in Virtual/Online MentoringI have regular access to a device with a high speed internet connection, a video camera and microphone to participate in an online interview, online training, and online volunteer opportunity. Contact Information SalutationPlease select... Mr. Ms. Mrs. Mx. Dr. Lt. Supt. Rev. First Name Last Name SuffixPlease select... MD Sr. Jr. I II III IV Esq. Ph.D. Email Confirm Email Street Address and Unit Number City StatePlease select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Puerto Rico Virgin Island Northern Mariana Islands Guam American Samoa Palau ZIP Cell Phone If you do not have a cell phone, please input your preferred number here. Home Phone Work Phone Emergency Contact Name Emergency Contact Relationship Emergency Contact Phone How did you learn about Boston Partners in Education?Please select... Big Cheese Reads/Gala Boston Partners Online Info Session Boston Public Schools College (*specify) Flyer Google Listserv Mayor's Mentoring Movement/My Brother's Keeper MBTA Ad Newspaper or Magazine (*specify) Nonprofit/Neighborhood/Community Organization (*specify) Other Internet Source (*specify) Social Media (*specify) TV/Radio/CSA Union Capital Boston Volunteer Fair (*specify) Volunteer Referral Program Word of Mouth Workplace (*specify) Please Specify Did a specific person refer you to us? If so, please share their name Background Date of Birth MonthPlease select... 1 2 3 4 5 6 7 8 9 10 11 12 DayPlease select... 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 YearPlease select... 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 GenderPlease select... Female Male Non-binary Race or Ethnicity you most identify with:Please select... Black, Afro-Caribbean, or African American East Asian or Asian American Latino or Hispanic American Middle Eastern or Arab American Native American or Alaska Native Non-Hispanic White or Euro-American South Asian or Indian American Other Prefer Not to Answer Are you the Parent or Guardian of BPS Student?YesNo At which school(s)? Did you attend a BPS school?YesNo Which school(s)? Due to your out-of-state address, please share your motivation for volunteering to support the Boston Public Schools, and/or your connection to the Boston area. 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 EducationNot ApplicableMarketingFundraisingVolunteer RecruitmentBPS Student/Family RecruitmentTechnical SkillsTranslating documentsLive interpretation/translation at eventsLeading workshops for other BPIE community membersOther Please briefly provide any relevant details Limit 100 Characters Work StatusPlease select... Retired School Transition Workforce Employer Job Title School Are you applying as part of a volunteer group or organization?YesNo Please specifyPlease select... Boston Arts Academy Boston Beauty Collective Boston College Read Aloud Program Boston Education Collaborative (BEC) Citylife Concord Baptist E2 - Excel/Elevate Initiative Equity Tutoring MA Office of the Inspector General New England Conservatory (NEC) Professor Shim/Boston University Verizon Do you speak any languages other than English?NoneCape Verdean CreoleChinese - CantoneseChinese - MandarinHaitian CreolePortugueseSomaliSpanishVietnameseOther Please Specify Are there any accommodations we should be aware of when finding the most successful match? Such as wheelchair access, closed captions.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 ArtsScienceArtCollege Prep 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 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 Virtual Mentoring No Preference Primary mode of transit:Please select... MBTA Car Bike Walking Convenient MBTA Line(s): Red Line Orange Line Green Line Blue Line Silver Line Commuter Rail Convenient Bus Line(s) Contact Information
