Please provide the following information:
*First Name:
*Last Name:
*Home Address:
*City: *State: Zip:
*Phone: *Cell:    
*Email: Place of Employment:
Emergency Contact: Phone:
If you are under 18 years old, please provide the following information:
Birthdate: School:
Parent(s)/Guardian(s) Name(s):
Parent(s)/Guardian(s) Phone Number(s): (H)    (W)
  I give permission for my son/daughter to volunteer with Read Aloud Delaware.
For what position would you like to volunteer?
    Reader Parent Educator Clerical Special Events Other
Please indicate availability: list in order of preference:
          Days of the Week Time of Day Site
Please indicate date, time and location of training session you will attend:
Can you read in another language? If so, which one(s)?
Special training, skills, or interests:

List past volunteer experiences and other organizations to which you belong:
Would you be interested in working on special events or displays?
Restrictions that might affect your availability for, or type of volunteer service (family, work schedule, transportation, etc.)
How did you hear about Read Aloud Delaware?
Please list two references not related to you (Community, Business, Present, or Past Employer). If you have previously worked with children, paid or volunteer, please list supervisor as a reference.
1. *Name: *Home Phone: *Work Phone:
  Job Title or relationship: Fax: Years known:
  *City: *State: Zip:
2. *Name: *Home Phone: *Work Phone:
  Job Title or relationship: Fax: Years known:
  *City: *State: Zip:
Have you ever been convicted of a crime? Yes  |  No  -  If yes, please provide explanation below.
In order to provide the safest environment for the children to whom we read, the staff of Read Aloud Delaware will conduct a reference check, a criminal history check, and may conduct an interview. Completion of this application does not guarantee acceptance into the program.
I certify that I have been informed and have agreed to these procedure.
I certify that the facts contained in this application are true and complete to the best of my knowledge.
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