Youth Volunteer Program Application

Click here to print the application

Name

First

Middle

Last

Street Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number

What school do you attend?

Cape Henlopen
Milford
Seaford
Sussex Technical

What grade are you in?

9th
10th
11th
12th

In 4-5 sentences please explain your interest in volunteering.

References

Reference #1

Name

First

Last

Street Address

Phone

How long have you known this person and in what capacity?

Reference

Reference #2

Name

First

Last

How you volunteering.

Street Address

Phone

How long have you known this person and in what capacity? (copy)

Volunteer Experience

Where have you volunteered previously and how many hours did you volunteer?

Start Date

End Date

Please provide a brief explanation of what tasks you did while volunteering.

Parent Approval

I, being the parent or legal guardian of (the “Minor”) hereby consent to and authorize the Minor to act as a volunteer for Pathways to Success. I acknowledge and agree that activities performed by the Minor as a volunteer will be performed strictly on a voluntary basis, without any pay, compensation, or benefits. I agree and understand that the Minor must comply with the rules and regulations established from time to time by Pathways to Success and that failure to do so may result in the Minor’s immediate removal as a volunteer.

Printed Name of Parent/Legal Guardian

Phone Number for Emergencies