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VOLUNTEER OPPORTUNITIES

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Volunteer Application

First Name

Last Name

Date of Birth

Cell Phone #

Home Address

City

State

Emergency Contact Information (Name, Address, Phone Number)

Professional background and volunteer information (Professional training, Certifications, Special Skills or talents related to potential volunteer experience)

Volunteer interest: please check the areas that fit your interest.

Drop in: support tutoring, hang out with teens, light clean up

Managing the Break (requesting weekly shift, monthly shift, or be on an as needed list; Must be over the age of 18 and granted permission for background check

Break teen Committee: Take on a role in leading the direction of the teen center

Break special events and fundraising committee: host events to fundraise and create more awareness of the Break

Music: lessons, recording, DJ music

Technology: Computers, movie nights, visual arts, etc

Art: Graffiti art, graphic art, design

Building Maintenance: Volunteers who haves skills set in building maintenance, repairs, and building projects

Other

Preferred days and times

Are you volunteering on behalf of an organization/company? If yes please provide the name below.

Background checks are required on any volunteer over the age of 18 that will have direct contact with any minors. Will you absorb this cost ($30) so that the Break can put the funds directly back into providing for the teens?

Yes

Statement of Agreement: I will not hold the BREAK, Break board members, or participant accountable for any injury that might occur during my work as a volunteer. I grant permission for the BREAK to review the required background check. I also grant permission for the taking and publishing of any photos taken during my work as a volunteer of the BREAK.

Please provide electronic signature and date below.

Your Signature

Select a date

Thank you for registering! We'll contact you shortly!

Background Check Form

Download and print this form after we call you for an interview!

OPEN HOURS

ADDRESS

CONNECT WITH US:

Monday: 4:00 - 8:00
Wednesday: 4:00 - 8:00

Thursday: 4:00 - 8:00
Friday: 5:00 - 10:00

Physical address:

6292 Northwest Highway

Crystal Lake, IL 60014

Mailing address:

PO Box 192

Crystal Lake, IL 60039-0192