Volunteer Application

Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code
Employment Status:
Place of Employment (Previous if Retired):
Job Title:
Cell Phone:*
Home Phone:
Email*
Date of Birth:*
*Must be 18 or older to volunteer.
Sex:
Race
- Asian
- Black
- Hispanic/Latino
- Native American
- White
- Other
Education:*
*A minimum of a high school diploma or equivalent is required for the tutor and lab volunteer positions.
Positions Interested In:*
- Tutor
- Computer Lab Volunteer
- Child Care
Days Available:*
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
Time Commitment:*
- Mornings
- Afternoons
- Evenings
*Note, most opportunities are available in the mornings or evenings. Child care is only available Tuesday/Thursday mornings.
How did you hear about us?
In addition to English, what language(s) do you know?
Have you ever been convicted of a crime other than a misdemeanor?
- Yes
- No
If Yes, please list date and charge:
Would you like to disclose any physical, mental, or medical challenges/disabilities? If so, please describe any accommodations you would require in order to perform your duties with Literacy Volunteers:
Why are you interested in working with Literacy Volunteers? If applicable, please comment on prior volunteer experience:
Please list any special skills/abilities or special interests that you would be willing to volunteer to Literacy Volunteers (e.g. graphic design, creative writing, party/special event planning, computer skills, media/community contacts.)
Emergency Contact - Please provide at least one emergency contact if possible:
Name:
Relationship:
Phone:
Personal References - Please provide at least one work/volunteer reference if possible:
Name:
Relationship:
Phone:
Name:
Relationship:
Phone:
I understand that the information on this application is subject to verification. I agree that if accepted as a volunteer, I will abide by the volunteer regulations as outlined by Literacy Volunteers of Greater Hartford.
Agreed to by:*
Date*
Date Format: MM slash DD slash YYYY

*If you did not receive confirmation or are having trouble submitting an application, please email rebecca.hawkins@lvgh.org.

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Student Stories:

“I didn’t realize how helpful LVGH would be. This isn’t the end for me here. I’m going to keep coming back and improve my skills.”

Jackie

“I like how welcoming and encouraging the tutors are. They were able to help me with my dyslexia and push me to reach my goals. I always had a passion for learning and when I came to LVGH I met even more people like me and I felt like I was home.”

Joey

“Since I’ve improved my English skills I am more independent. I can go shopping, visit a doctor or fix an internet problem with a company over the phone, easily; that’s not a big deal for me anymore.”

Kelcillene

“Education helps you realize your potential, which allow you to empower yourself to do more than you thought you could do before.”

Winston

“After joining Literacy Volunteers of Greater Hartford (LVGH) I feel confident to go out with my children. It changed my life.”

Lila

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Students’ lives will change and so will yours. Become a volunteer. More…

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LVGH
30 Arbor Street
Hartford, CT 06106
First Floor South Building

Phone (860) 233-3853
Fax (860) 838-6442