MASTER VOLUNTEER IN CLOTHING CONSTRUCTION PROGRAM. Volunteer Application Form

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Transcription:

MASTER VOLUNTEER IN CLOTHING CONSTRUCTION PROGRAM Volunteer Application Form The Kentucky Cooperative Extension Service takes seriously its obligation to provide a safe environment for all persons involved in its youth and adult activities. This application is supplemental to the UK CES Volunteer Application and is designed to be an informationgathering tool to assist in the selection of qualified Master Clothing Volunteer candidates. I. GENERAL INFORMATION (Please complete in black ink.) Name: (First) (Middle) (Last) Mailing Address: (Street, Box, Route, Apt. #) (City) (State) (Zip) Residential Address: (IF DIFFERENT FROM ABOVE) (Street, Box, Route, Apt. #) (City) (State) (Zip) Telephone number: Day: ( ) Best time to call: a.m/p.m. E-mail: Evening: ( ) Best time to call: a.m/p.m. Cell: ( ) Best time to call: a.m/p.m. Fax: Sex: Female Male Occupation: Employer: 1. Do you have any special needs? If yes, please describe: 2. Have you completed a UK CES Volunteer Application and been accepted as a volunteer? No Yes, in County. 3. Have you applied for the Kentucky Master Volunteer in Clothing Construction Program prior to this application? No Yes, when? (give the year) in County B-5

4. Have you done other volunteer work? No Yes Please describe:. 5. When could you be available for an interview? Check () all that apply. morning afternoon evening 6. Would you be willing to travel to another county in the area for an interview? Yes No II. VOLUNTEER S SKILLS & INTERESTS 1. How do you classify your sewing skills? Beginner Intermediate Advanced (tailoring) seamstress? 2. How long have you been sewing? Years 3. Check the types of garments/items you have made. skirts/slacks/shorts with elastic waist skirts/slacks/shorts with waistband casual dresses formal wear tailored blouses/shirts simple tops children's play clothes tailored jackets (blazers) children's dressy clothes costumes draperies/home furnishings Other; please list: 4. How much time do you currently spend sewing or in other sewing-related activities? very little frequently occasionally extensively 5. Check ( ) the types of fabrics you have used in sewing items: wovens, such as poplin, sportscloth, broadcloth. wovens, such as voile, lawn, batiste. wools and woolen fabrics. silky wovens, such as crepe de chine, polyester jacquards, tissue silk. heavy wovens, such as denim, corduroy, suit-weight linen. stable knits, such as double knit. other knits, such as T-shirt, sweater, sweatshirt, fleece. knit, such as bathing suit or two-way stretch knits. Other: Please specify: B-6

6. Have you ever, or do you presently sew for pay? No Yes, please respond to the questions below: How long have you sewn for pay? What type of sewing do you do or have you done? Check () all that apply. alterations and renovations sewing of new fabric items household articles (draperies, slip covers, etc. costumes Other: 7. Do you currently alter clothing for yourself and/or others: Yes No III. EDUCATION, TRAINING, EXPECTATIONS 1. Education Level: Check () highest earned. 8 th grade or below High school diploma Attended high school Vocational school GED College or professional degree Degree: 2. How did you learn to sew? Check () the best answer provided. Mother, relative or friend self taught 4-H Other: Explain 3. Have you had any formal training in sewing? No Yes, please answer below. Check () all that apply. Sewing machine / fabric store class(es) High school College / University Extension Homemaker lesson / leader training Master Clothing Volunteer led class(es) Adult Education [list course(s) titles] When (approximate date) 4-H leader training TV seminars/video tapes Other: Explain B-7

4. Why are you interested in becoming a Kentucky Master Clothing Volunteer? IV. PERSONAL REFERENCES List the complete names and addresses of two persons who know about your sewing skills. NAME: Home Phone: Work Phone: Address: Street City State Zip Code How do you know this person? NAME: Home Phone: Work Phone: Address: Street City State Zip Code How do you know this person? I authorize the contact of the references listed previously in this application. I also understand that the misrepresentation or omission of information requested is just cause for nonappointment/termination/disengagement as a volunteer. If accepted as a candidate in this program, I agree to abide by the standards of the Kentucky Cooperative Extension Service and to fulfill the volunteer responsibilities to the best of my ability. I understand the purpose of the Kentucky Master Volunteer in Clothing Construction Program is to help extend sewing education to others in my community. I recognize that the Kentucky Master Volunteer in Clothing Construction Program is a part of the College of Agriculture Food and Environment Cooperative Extension Service, in which the University of Kentucky, Kentucky State University and all Kentucky counties share. As a volunteer, I am committing to involve individuals regardless of race, color, age, sex, religion, disability, or national origin in educational experiences in cooperation with other Extension volunteers and Extension personnel. Applicant Signature: Date: MCV Contact Agent Notebook Revised 4.2004; MMB-2/2006; 3/2016 Educational programs of the Kentucky Cooperative Extension serve all people regardless of race, color, age, sex, religion, disability or national origin B-8

Kentucky Cooperative Extension Service Volunteer Reference Form The following individual is applying to become a Master Clothing Volunteer with the Kentucky Master Volunteer in Clothing Construction Program. This outreach program is operated and managed by the Kentucky Cooperative Extension Service. Your name was listed as a reference. Applicant s Name: Date: Mission Statement for Kentucky Cooperative Extension Service The Kentucky Cooperative Extension Service serves as a link between the counties of the Commonwealth and its two land grant universities to help individuals improve their lives through an educational process focusing on addressing issues and needs. We emphasize: valuing diversity and capitalizing on its potential to strengthen programs being locally-driven, flexible, and responsive identifying and supporting high priority statewide programming thrusts educating people to solve problems, make decisions, and embrace change applying knowledge and research-based information accomplishing work through collaboration, volunteerism, and leadership development fostering empowered and contributing people developing youth, adults, families, and communities fostering effective lifelong use of personal and natural resources Mission Statement for Kentucky Master Volunteer in Clothing Program The Kentucky Master Volunteer in Clothing Construction Program prepares and nurtures volunteers to perpetuate sewing through the sharing of the skills and knowledge with others in the community. Over B-11

1. How long have you known them? 2. What is your relationship to this person? (relative, friend, co-worker, etc.) 3. What do you think are the applicant s strengths and weaknesses as they apply to become a Kentucky Master Clothing Volunteer? Strengths: Weaknesses: 4. Please summarize the applicant s leadership, organizational, and teaching skills. 5. Would you be willing to place your child, or any other child for whom you are responsible, under their supervision? Yes No 6. Do you consider this person to be a positive role model for youth and/or adults? Yes No Explain your response: 7. In comparison with persons you have known how would you rate the applicant in the following areas? Below Above Do Not Average Average Average Outstanding Know Emotional maturity Leadership Enthusiasm and energy Self-confidence Sense of humor Handling emergencies Understanding of children Verbal communication skills Dependability Patience Ability to work with children Ability to work with adults Sewing skills Knowledge of sewing B-12

8. Please comment on your knowledge of this person s interest and ability in teaching and/or sharing sewing skills and knowledge with others in the community. Thank you for your comments! Person providing reference: Please print Signature: Date: Please return in the envelope provided. For Office Use Only: Complete this portion if interview was conducted by telephone. Date of Telephone Interview: Interviewer s Signature: VolReferFrm.doc MCV Contact Agent Notebook Revised 4/2004; MMB-4/2006, 3/2014 Educational programs of the Kentucky Cooperative Extension serve all people regardless of race, color, age, sex, religion, disability or national origin B-13