CONTACT INFORMATION
Please enter today's date (Format: dd/mm/yyyy)
Salutation
--None-- Mr. Ms. Mrs. Dr. Prof. Rev. Sister Rabbi
First Name
Last Name
Home Address
City
State/Province
Zip
Country
Location Where You Live
--None-- South Bay East Bay San Francisco Other
Neighborhood Where You Live (EB=East Bay; SF=San Francisco; SB=South Bay)
--None-- EB-Alameda EB-Albany EB-Antioch EB-Berkeley EB-Castro Valley EB-Concord EB-Danville EB-Dublin EB-El Cerrito EB-El Sobrante EB-Emeryville EB-Fremont EB-Glenview EB-Hayward EB-Hercules EB-Kensington EB-Lafayette EB-Martinez EB-Millsmont EB-North Berkeley EB-Oak Knoll EB-Oakland EB-Oakland-China Hill EB-Oakland-Chinatown EB-Oakland-Dimond District EB-Oakland-Downtown EB-Oakland-East EB-Oakland-Eastmont Mall EB-Oakland-Fruitvale EB-Oakland-High St. EB-Oakland-Hills EB-Oakland-Jack London EB-Oakland-Lake Merritt EB-Oakland-Laurel EB-Oakland-Maxwell Park EB-Oakland-North/Temescal EB-Oakland-San Antonio/Eastlake EB-Oakland-Temescal EB-Oakland-West Oakland EB-Oakmore EB-Orinda EB-Piedmont EB-Pinole EB-Pittsburg EB-Pleasant Hill EB-Pleasanton EB-Redwood Heights EB-Richmond EB-Ridgemont EB-San Leandro EB-San Lorenzo EB-San Pablo EB-Union City EB-Walnut Creek SB-Almaden SB-Alviso SB-Atherton SB-Belmont SB-Berryessa SB-Campbell SB-Cimarron SB-Commodore SB-Cupertino SB-Evergreen SB-Los Altos SB-Los Gatos SB-Menlo Park SB-Millbrae SB-Milpitas SB-Morgan Hill SB-Mountain View SB-Newark SB-Palo Alto SB-Peninsula SB-Redwood City SB-San Bruno SB-San Carlos SB-San Jose SB-Santa Clara SB-Saratoga SB-Sierramont SB-Sunnyvale SB-Sunol SB-Sweigert SB-Willow Glen SF-Balboa Terrace SF-Bayshore SF-Bayview SF-Bernal Heights SF-Brisbane SF-Broadmoor SF-Burlingame SF-Castro SF-Chinatown SF-Colma SF-Cow Hollow SF-Crocker SF-Crocker Amazon SF-Daly City SF-Downtown SF-Excelsior SF-Financial District SF-Glen Park SF-Haight-Ashbury SF-Hayes Valley SF-Hillside SF-Hunter's Point SF-Ingleside SF-Marina SF-Merced SF-Mission Bay SF-Mission District SF-Nob Hill SF-Noe Valley SF-North Beach SF-Oceanview SF-Outer Richmond SF-Pacific Heights SF-Pacifica SF-Peninsula SF-Portola SF-Potrero Hill SF-Presidio SF-Richmond SF-Russian Hill SF-San Mateo SF-Soma SF-South San Francisco SF-Southeast SF-St. Francis SF-Sunset SF-Tenderloin SF-Twin Peaks SF-Visitacion Valley SF-Western Addition
Please write the name of your home neighborhood if it is not listed
Mobile phone
Home Phone
Email Address
Emergency Contact (Please include the Emergency Contact's name and relationship to you.)
Emergency Contact Phone Number
PERSONAL INFORMATION
Birth Date (Format: dd/mm/yyyy)
Gender
--None-- Male Female
Native Language
Other Languages
Optional - Ethnicity
Optional - Marital Status
--None-- Divorced Married Separated Single Widowed
Optional - SocioEconomic Status
--None-- Low Income Low-Middle Income Middle Income Middle-High Income High Income
Do you have any special skills you would like to share with RT? (e.g. fundraising experience, website/computer skills, translation abilities)
Check if you have been convicted of a felony
Check if you have been convicted of a misdemeanor
Please explain your felony or misdemeanor conviction (if applicable)
Check if you allow Refugee Transitions to use photographs that include you for promotional materials
EMPLOYMENT INFORMATION
Employment Status
--None-- Full-time Part-time Temporary Volunteer/Intern Contractor Student Unemployed Retired Looking for Employment
Occupation
Employer
How long have you been employed at this position?
--None-- less than one year 1-2 years 2-4 years 4-6 years 6-10 years Over 10 years
Work Phone
Check if it is okay to call you at work
EDUCATION INFORMATION
Highest Education Level
--None-- Elementary Secondary High School Undergraduate Graduate Technical/Associates
Check if you have received a college degree
Colleges/Universities Attended
College: Graduation Date (Format: dd/mm/yyyy) (Please enter your college graduation date or the anticipated date. The exact day doesn't matter.)
College Major
Check if you have received a graduate degree
Graduate Schools Attended
Graduate School: Graduation Date (Format: dd/mm/yyyy) (Please enter the date you graduated from graduate school or the anticipated date. The exact day doesn't matter.)
Graduate Field of Study
Other Schooling (Please enter any other schooling.)
VOLUNTEERING PREFERENCES
Although we may not be able to accommodate all of your preferences, your preference profile will help us determine an appropriate student match for you. Please fill out the following information to the best of your ability, and there will be an opportunity to change or specify your preferences during the interview. If you need more information about our various programs, please refer to our website. In this section of the application, you can select more than one choice by holding down the CTRL key and clicking on multiple choices.
Preferred Program
Home-based ESL After School Tutoring: SFIHS After School Tutoring: OIHS Site-based Class Home-based Class/Small Group Unsure
Preferred Location
East Bay South Bay San Francisco No Preference
Preferred Neighborhood (EB=East Bay; SF=San Francisco; SB=South Bay)
No Preference EB-Any place BART accessible EB-Alameda EB-Albany EB-Antioch EB-Berkeley EB-Castro Valley EB-Concord EB-Danville EB-Dublin EB-El Cerrito EB-El Sobrante EB-Emeryville EB-Fremont EB-Glenview EB-Hayward EB-Hercules EB-Kensington EB-Lafayette EB-Martinez EB-Millsmont EB-North Berkeley EB-Oak Knoll EB-Oakland EB-Oakland-China Hill EB-Oakland-Chinatown EB-Oakland-Dimond District EB-Oakland-Downtown EB-Oakland-East EB-Oakland-Eastmont Mall EB-Oakland-Fruitvale EB-Oakland-High St. EB-Oakland-Hills EB-Oakland-Jack London EB-Oakland-Lake Merritt EB-Oakland-Laurel EB-Oakland-Maxwell Park EB-Oakland-North/Temescal EB-Oakland-San Antonio/Eastlake EB-Oakland-Temescal EB-Oakland-West Oakland EB-Oakmore EB-Orinda EB-Piedmont EB-Pinole EB-Pittsburg EB-Pleasant Hill EB-Pleasanton EB-Redwood Heights EB-Richmond EB-Ridgemont EB-San Leandro EB-San Lorenzo EB-San Pablo EB-Union City EB-Walnut Creek SB-Almaden SB-Alviso SB-Atherton SB-Belmont SB-Berryessa SB-Campbell SB-Cimarron SB-Commodore SB-Cupertino SB-Evergreen SB-Los Altos SB-Los Gatos SB-Menlo Park SB-Millbrae SB-Milpitas SB-Morgan Hill SB-Mountain View SB-Newark SB-Palo Alto SB-Peninsula SB-Redwood City SB-San Bruno SB-San Carlos SB-San Jose SB-Santa Clara SB-Saratoga SB-Sierramont SB-Sunnyvale SB-Sunol SB-Sweigert SB-Willow Glen SF-Any place BART accessible SF-Balboa Terrace SF-Bayshore SF-Bayview SF-Bernal Heights SF-Brisbane SF-Broadmoor SF-Burlingame SF-Castro SF-Chinatown SF-Colma SF-Cow Hollow SF-Crocker SF-Crocker Amazon SF-Daly City SF-Downtown SF-Excelsior SF-Financial District SF-Glen Park SF-Haight-Ashbury SF-Hayes Valley SF-Hillside SF-Hunter's Point SF-Ingleside SF-Marina SF-Merced SF-Mission Bay SF-Mission District SF-Nob Hill SF-Noe Valley SF-North Beach SF-Oceanview SF-Outer Richmond SF-Pacifica SF-Pacific Heights SF-Peninsula SF-Portola SF-Potrero Hill SF-Presidio SF-Richmond SF-Russian Hill SF-San Mateo SF-Soma SF-Southeast SF-South San Francisco SF-St. Francis SF-Sunset SF-Tenderloin SF-Twin Peaks SF-Visitacion Valley SF-Western Addition
Preferred Student Age Range
Adult Elementary School High School Middle School Senior (65+) No Preference Transitional Youth (18-24)
Preferred Student Region/Country
Preferred Student Spoken Language(s)
Volunteer Special Interest(s) (Do you have any other special interests? If so, please include those here.)
Times Available
Weekdays Weeknights Weekends
Date Available to Start (Format: dd/mm/yyyy)
Check if you own a car
REFERENCES
Please provide the name and contact information for two references. If you are unable to do so at this time, please bring your reference information to your interview.
Reference #1 Name
Reference #1 Organization
Reference #1 Title
Reference #1 Address
Reference #1 Phone
Reference #2 Name
Reference #2 Organization
Reference #2 Title
Reference #2 Address
Reference #2 Phone
VOLUNTEER AGREEMENT
Your signature is your "legally-binding contract" to Refugee Transitions that all the information you have provided in your application is accurate and completed to the best of your knowledge. In addition, you also agree to the following terms:
I understand that the agency has to take the best interests of its clients into consideration first. In order to assure their safety and protection, it is the policy of Refugee Transitions to conduct criminal background checks on our volunteers.
I authorize Refugee Transitions to conduct a background check on myself and I will submit the required fingerprints upon request by Refugee Transitions staff.
I understand that Refugee Transitions' volunteers who tutor at school sites need to comply with school district policies and complete a tuberculosis screen.
I have read and agree to the terms stated above. Volunteer Signature (Please type your name)
How did you hear about Refugee Transitions? Please select all that apply.
Website Online Posting Employer TV/Radio Friend Newspaper Volunteer Center Peace Corp Library/Project Read Universities/Schools Other RT Staff/Volunteer/Board Member Flier
If you were referred to RT by another source, please specify.