PARTNERSHIP For FAMILY HEALTH

Northern Manhatten HIV Consortium

Volunteer

Success in school helps kids with HIV/AIDS feel normal.
Success in school gives positive families more hope for the future.

The Afterschool Program of the Partnership for Family Health provides academic tutoring, mentoring, art exposure, music appreciation and instruction for all ages, lifeskills/job readiness seminars and college preparation for older youth.

Academic tutoring is geared to the individual student. Most students need help with junior-high level mathematics, reading comprehension, writing, vocabulary enrichment and test-taking skills.

Flexible afterschool tutoring sessions are arranged at the clinics (St. Luke's Roosevelt Hospital Center for Comprehensive Care and Metropolitan Hospital's Special Family Assistance Program) or at public libraries near students' homes in northern Manhattan and the Bronx.

Volunteer candidates who can commit to one full year (12 months) of service will be preferred over those who can only commit to a shorter period.

Volunteer Requirements
for
Tutoring and Mentoring Children and Youth

  1. Commitment to at least 2 hours of volunteer effort per week for at least one full semester (one full year is preferable).
  2. Submission of the following application.
  3. Initial interview with the coordinator.
  4. Orientation and training workshop - approximately two hours.
  5. Negative test for TB within the previous 12 months.
  6. Immunizations as required by the School Immunization Law (NYS).

The Afterschool Program Volunteer Tutoring and Mentoring Application 2005-06

The following information is requested in order to determine participation in the Afterschool Program and to help make appropriate matches between volunteer tutors/mentors and students. Please respond to all questions and describe your qualifications in detail.

Download PDF versionMentoring App 05-06 PDF

* Required Fields are marked by an asterisk.
First Name*
Last Name
Social Security #
Date of Birth
mm dd yyyy
Primary Phone
Alt. Tel.
Email Address
Street Address
Apt.
City
State
Zip Code
Country
What is the highest academic level you have completed thus far?

Area of Study or Current Employment
School / Employer's Name
School / Work Address
Work Phone
Work Fax
What grade levels and subjects do you feel competent to tutor? (Check all.)
Kindergarten - 3rd Grade 4th - 8th Grades 9th - 12th Grades Mathematics Reading ESL Test Prep Writing

Other(explain)
If you play a musical instrument, would you be interested in giving lessons? Below please note the instrument(s) on which you feel competent to instruct a beginner:

How long can you commit to this volunteer service?
One year
Less than one year

What do you believe you have to offer the children, youth and families participating in our Afterschool Program? (Be sure to include special interests, hobbies or skills that you feel you can share with students.)


List clubs, associations, organizations or civic groups that you have belonged to:
Have you ever been convicted of a crime other than a parking violation?

If yes, what was the offense? Please provide a description and the date of each incident.

School, Employment, and Volunteer History (past 5 years)

1st Example

Sch./Employer's Name, Address, & Telephone

Title & Responsibilities

Years of Employment & Reasons for Changing


2nd Example

Sch./Employer's Name, Address, & Telephone

Title & Responsibilities

Years of Employment & Reasons for Changing


3rd Example

Sch./Employer's Name, Address, & Telephone

Title & Responsibilities

Years of Employment & Reasons for Changing


References

Please list two people (other than relatives) who have known you for at least three years and who can serve as character references:

Reference ONE
Name
Relationship to Applicant
Day Phone
Street Address
Apt.
City
State
Zip Code


Reference TWO
Name
Relationship to Applicant
Day Phone
Street Address
Apt.
City
State
Zip Code



Thank you for your interest in our program. You will be notified by telephone or email regarding the interview which is required for volunteers in the Afterschool Program.