The Become A Mentor!! MENTORING PROGRAM 2010 The Crossroads School Mentoring Program connects students from Crossroads with professionals who work in neighboring companies. Mentors volunteer an average of two hours per month, providing guidance and a listening ear to students. Through open dialogue, arts, and activities, mentors and their students are able to build lasting relationships that may extend well beyond their middle school experience. All mentoring activities are planned by the school counselor, mentors are only required to eagerly attend their scheduled sessions and cultivate relationships with their students! We welcome new mentors in the Baltimore area who are dedicated to improving the lives of our youth. We meet two times per month for an hour, beginning in October and ending in May. Mentoring sessions for the 2014-2015 school year will be on Fridays from 12:40 1:40 p.m. The core mission of The Crossroads School is to raise student achievement by combining rigorous academic standards and hands- on learning experiences. Serving 160 students, The Crossroads School is a public charter 6-8 grade middle school located in Fells Point operated by the Living Classrooms Foundation. Our cross- disciplinary, hands- on approach has led to unprecedented success, and many of our students go on to Baltimore s best public or private high schools. Enrichment opportunities are offered to broaden students horizons and encourage them to express themselves beyond the work they do in their core courses. If you are interested please contact Bethany Cochol, School Counselor, at bcochol@thecrossroadsschool.org, or Rebekah Lin Meyer, Living Classrooms Foundation s Director of Community Outreach and Volunteerism, at Rmeyer@livingclassrooms.org.
The Crossroads School Mentoring Interest Survey Thank you for your interest in becoming a mentor for The Crossroads School. To help us to better match you with a student and to learn more about you please fill out this quick survey. Thank you! Name Company Title Phone Email Male Female How did you hear about the mentoring program? Special interests/hobbies/likes Why would you like to be a mentor? Have you had previous mentor experience? Where?
Living Classrooms Foundation Volunteer Application Packet Part 1: Volunteer Application (Please print or type legibly and complete this form as thoroughly as possible) I. General Information Last name: First name: Middle name: Street address: City: State: Zip: Primary phone: Email: Alternate phone: Other relevant contact information: Date of birth: Gender: Emergency contact name: Phone: Relationship: Email: II. Interests/Experience Employed/Student/Retired? Employer/School: Address: Title/Position: Phone: May we contact if necessary: Are volunteer hours required for a class or community service credit? If yes, please explain: Name of college/school/organization that requires completion: Number of hours required: Required date of completion:
Why are you interested in volunteering with Living Classrooms Foundation? How did you hear about volunteering with Living Classrooms Foundation? Current or previous volunteer experience: Educational background, hobbies, or special interests: Area(s) of interest: For example, after-school programs, workforce development, environmental programs, etc. Have you volunteered/worked at Living Classrooms Foundation in the past? If yes, when? If yes, in which area(s)? If yes, who was your supervisor? Do you know any current Living Classrooms Foundation staff or volunteers? If yes, please supply name(s) Relevant experience/other information: Please list any other relevant experience or additional information that you would like to share: III. References Please provide the name, contact information (email and phone number), and your relationship to two references. 1. 2.
IV. Background Check Living Classrooms Foundation requests the following information because of our dedication and commitment to the students and community that we serve. All youth-serving organizations must take reasonable precautions when appointing adults who work with children. Please note that a prior conviction will not necessarily be a bar to your acceptance as a volunteer. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation, and desired volunteer role will be taken into account. Note: You are not obligated to disclose expunged charges. In addition to your responses to these questions, all volunteers will be checked against online sources of public records, including the National Sex Offender Registry and Maryland Judiciary Case Search websites. Additional background checks and drug tests may be required for certain volunteer positions. Have you ever been convicted of a crime? (e.g., felony or misdemeanor including DWI, DUI, etc., but not including minor traffic violations or any convictions as a youthful offender) Yes No If yes, state offense, date, and location Have you ever been arrested or convicted for the use or sale of illegal drugs? Yes No If yes, state offense, date, and location Have you ever been convicted of child neglect or abuse? Yes If yes, explain No V. Signature By signing below, you acknowledge that all information on this application form is true, complete, and correct. Any questions related to volunteer policies or procedures should be directed the Rebekah Meyer, Director of Community Outreach and Volunteerism, at Rmeyer@livingclassrooms.org or 410.685.0295, ext. 431. Signature Date
Part 2: Volunteer Agreement To ensure the safety of all Living Classrooms Foundation volunteers, staff, and participants, volunteers are asked to agree to the following statements. Additional details about volunteer policies can be found in the Living Classrooms Foundation Volunteer Manual. Copies of this Manual can be accessed by contacting the Director of Community Outreach and Volunteerism. 1. Volunteers must complete required paperwork (volunteer application packet) and attend an orientation or other training session before being placed with a program. 2. Volunteers will be asked to comply with basic background check procedures. 3. Volunteers will always be supervised by a staff member and should never be alone with students/program participants. 4. The lasting impression that volunteers make on those they serve and work with reflects directly on all staff, volunteers, and board members of Living Classrooms Foundation. All words and deeds of volunteers should be in support of Living Classrooms Foundation and its programs reputation for quality. 5. Volunteering with Living Classrooms Foundation is at-will and can be ended by the volunteer or the Foundation at any time, with or without cause. If you wish to leave your volunteer service, please contact your supervisor so that appropriate arrangements can be made. 6. As a volunteer with Living Classrooms Foundation, you may have access to confidential information regarding program participants, staff, or organization policies. Volunteers must refrain from sharing confidential information with others. 7. Although we do our best to provide safe conditions for our volunteers, we count on volunteers to be the best protector of their own personal safety. Volunteers should always be aware of where they are and what they are doing. Volunteers should pay particular attention to safety instructions and proper equipment use. Volunteers should speak up if they have a safety concern or any other questions. Due to the unique nature of many Living Classrooms Foundation sites, additional safety instructions and policies may be presented as needed. Print full name: Signature: Date:
Part 3: Volunteer Release VOLUNTEER RELEASE Adults (ages 18 and over) I, (print FULL name), the undersigned, as a volunteer for Living Classrooms Foundation, Inc., (LCF) understand that I will be exposed to certain risks that, by the nature and location of the activities cannot be controlled. I agree to release and forever discharge LCF, their Officers, Board of Trustees, Employees and Agents, from any and all liability, damages, claims, or causes action, arising out of or in any way connected with my participation in volunteer activities at LCF. I further agree to indemnify and hold forever harmless LCF for liability, damages, claims or causes of action made or brought by me or by anyone on behalf of me as a result of or in any way connected with my volunteer activities at LCF. I acknowledge that LCF reserves the right to video, photograph, or record any volunteer activities associated with LCF. MEDIA RELEASE In consideration of my engagement as a subject and other consideration herein acknowledged as already received, and without further consideration or compensation now or in the future, I hereby give Living Classrooms Foundation and its legal representatives and assigns the right and permission to publish images of me and statements by me as captured through photography, videography, audio recording, and written communication while participating in Living Classrooms and affiliate programming and as a program graduate. I further authorize modification of these images and statements for correctness and artistic effect so long as the changes do not result in intentional and harmful misrepresentation. Without time constraint and without further notification, these images and statements may be used with or without appropriate identification of me by name, employer, age, and/or affiliation(s) with Living Classrooms Foundation in any Living Classrooms publication or communication (e.g. web pages, multimedia presentations, television commercials, promotional literature, fundraising collateral materials, advertising, and participant recruitment campaigns) whether print, electronic, or broadcast. Printed Name: Signature: