First Name     Last Name

Email Address

Phone 1     Phone 2

Mailing Address

City     State     ZIP

Describe your educational background.

 

Describe your work experience.

 

What are your interests and/or hobbies?

 

Describe your computer knowledge, including software applications you know.

 

Check the volunteer activities you’re interested in:
One-to-One Tutoring in  Reading    Math    Science    Writing    Social Studies    ESL    Other (Please describe below.)   
Science Club 
Garden Project  
Workplace Skills/Career Exploration 
Mentoring  
Fundraising  
Public Relations 
Office Fix-up/Maintenance 
Book Drives/Library Management 
Clerical/Receptionist 
Other Volunteer Activity (Please describe below.)

Check the locations/class sites you can work at:
Harrisburg City (Mornings, Afternoons, Evenings) 
Tri-Community Elementary School, Bressler (Mornings)

Check the days and times you are available:
Mornings  Monday    Tuesday    Wednesday    Thursday    Friday    Saturday   
Afternoons  Monday    Tuesday    Wednesday    Thursday    Friday    Saturday   
Evenings  Monday    Tuesday    Wednesday    Thursday    Friday    Saturday   

Photo release:
I give my permission and consent to be photographed during OIC activities. I further give permission and consent for OIC to publish and use such photographs to illustrate and promote the OIC experience and programs. 

Enter additional comments, information, or questions here.