Personal Information

First Name:       Last Name: 

Driver's License #:       Street Address: 

City:    State:    Zip Code: 

Home Phone:    Business Phone: 

E-mail Address: 

Employment

I am presently:  Working Full Time Working Part Time Unemployed Retired Student Other

Job/Title Position:    Company: 

Street Address: 

City:    State:    Zip Code: 

Education

Please indicate highest level of education:  High School Graduate Attending College College Graduate Graduate School Other

Previous Experience / Skills

Please briefly describe your experience/skills below:

Where do you wish to volunteer?:  Pendleton Juvenile Correctional Facility North Central Juvenile Correctional Facility Madison Juvenile Correctional Facility South Bend/Camp Summit Juvenile Correctional Facility AIM Support Center - Indianapolis

Volunteer Positions

Indicate which you intend to become involved in:

College Internship (enrolled)  Community Mentor

References

Please enter three work and character references:

For the safety of the youth, normal employment verification such as contacting references and criminal background checks may occur. By submitting this form you authorize AIM to make these verifications.

Statement of Committment

As a volunteer working with A.I.M. youth, I agree to:

• Attend a mandatory orientation and training sessions that may be necessary to help me in my volunteer position.

• Abide by all Department of Correction Rules and policies that apply to me.

• Abide by guidelines and policies of AIM.

• Honor the commitment to work as scheduled. If I must deviate from the scheduled commitment, I will notify the appropriate person in advance.

To submit this application, you must check the box below.

 I Agree