Volunteer Inquiry Form Volunteer Inquiry Form Step 1 of 3 33% PLEASE NOTE: You will not be able to save this form while completing it, so please allow yourself time to complete the form entirely in one sitting.Name* First Last M.I. Nickname (if any) Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Daytime Phone*Primary Email Address* Emergency Contact Relationship Emergency Phone How did you hear about TaLL? Were you referred by a person or organization? I am interested in (click all boxes that apply): As a Lead ESL Teacher Training to become an ESL Teacher As an Arabic translator (facilitating communication between tutoring teams and refugee families) Teaching English to Syrian adults/parents in their home Helping refugee children and teens with their homework Supporting TaLL’s volunteer recruitment efforts Supporting TaLL’s fundraising efforts Other (please specify below if Other) Other ways you'd like to help Please answer the following questions as completely as you can, trying to limit your responses to 250 words or less.Why do you want to volunteer with TaLL?Have you any experience with teaching, tutoring, or ESL (English as a Second Language)? If so, please describe.Please list any teaching-related credentials or certifications you may have:If you haven’t already done so, are you willing to complete a free 13-hour Laubach training on teaching English as a Second Language? Yes No Please upload plain-text résumé in the space below or attach a Word or PDF file to your application email. Alternatively, please list all places worked in the last 10 years. Include organization names and locations, as well as your title for each and dates worked. If you have no work history (you've never been employed), please enter "N/A."Upload résuméMax. file size: 256 MB.If no résumé was uploaded above, please list your work experience here:Please describe any experience you’ve had interacting with people from cultures different from your own.Please describe any additional training or special skills you may have acquired through employment, volunteer service, or life experience (facilitating trainings, fundraising, etc.):Please list any community service or grassroots organizations in which you currently participate or have in the past.Is there any other autobiographical information that we should know?Please list any hobbies or special interests you have:Adopting, or sponsoring a Syrian refugee family is not necessary to volunteer. If you have “adopted” a family or plan to do so, please provide us with your family’s information for our database.Family's Name: Family's Address: Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Family's Phone:I’m interested in receiving information from the Syrian Community Network/Heart 4 Refugees about adopting a Syrian refugee family. Although, we know schedules are often in flux, offer general windows of time you are likely be available in the coming months. For example, I am generally free Tuesdays and Thursdays from 1:30-4:30 PM. I am usually available: Please share any concerns or time constraints you may have.We provide in-home tutoring to many refugee families who live throughout the greater San Diego area, many in El Cajon or City Heights. Volunteers will need to provide their own transportation.Please note: 1) For applicants who have not lived in the State of California for the past 5 years, TaLL will conduct a background check in the previous state(s) of residency. 2) Any applicant found to have been convicted of, or having charges pending for, a felony or misdemeanor involving a sexual offense, child abuse or neglect, or related acts that would pose risks to children or TaLL will be rejected.Have you lived outside of California in the past 7 years? Yes No Please list all addresses outside of California and/or the U.S. for the past 7 years to the best of your ability. Include dates of residency. If you have lived outside the U.S. in the past 2 years, please specify current U.S. citizenship status (permanent resident, visa, green card, etc.).Have you been convicted of a crime in California or another state, federal court, the military, or a jurisdiction outside the U.S. Yes No Disclose all convictions, including all DUI convictions. Indicate if you received a certificate of rehabilitation of if the conviction was later dismissed, or the sentence was suspended.Have you had at least one major moving violation* in the past 4 years and/or more than three minor moving violations in the past 3 years, in California or any other state. <em>(*Minor moving violations include, but are not limited to: speeding, making an unsafe lane change, and running a red light. Major moving violations include, but are not limited to: driving under the influence (DUI), reckless driving, and driving with a suspended, revoked, or invalid license.)</em> Yes No Have you been directly involved with a court proceeding in California or another state. Yes No If I volunteer with Teach & Learn Literacy, I would agree to (please check all that apply):* Volunteer for a minimum period of 12 months Participate in ongoing supervision and training workshops or meetings Maintain confidentiality regarding refugee families’ personal information Submit to a fingerprint-based criminal index and investigation background check (including FBI, DOJ, Child Abuse Central Index and Megan's Law sexual offender registry) Have and maintain a valid driver's license *Please list any concerns you might have about the above items: