Become A OneLife Tutor – OneLife Tutoring

Our program has up to 20 students each matched to one tutor for the school year. We are always looking to add volunteer tutors to our team. Our tutors help with homework that the student brings. If they have no homework, we read leveled books; play math board games; and practice reading or math on computer tablets. We match tutors one-to-one since this is most effective and we always have certified teachers present to assist as needed.

Application Form

The purpose of this form is to notify you that a pre-volunteering background and reference check will be conducted on you in the course of consideration to volunteer with OneLife Tutoring. All applications will be kept confidential & secure by the Director of Tutoring and OneLife Community Church staff. We are so excited you are getting involved and can’t wait to have you be a part of our team!

Today's Date:

Personal Information

First Name:

Middle Name:

Last Name:

Date of Birth:

Your email:

Address (City, State, Zip):

Phone:

Please list your residences over the last seven years (include city and state):

Occupation:

Employer:

How long employed?

Marital Status (optional)
MarriedEngagedWidowedSeparatedDivorced
Do you have children?
YesNo
If yes, please list their names and ages (optional)

Please explain any "yes" answers to the following questions in the box following question 4

1. Are there any facts or circumstances involving you or your background that would call into question your involvement in an environment where children or youth may be present? (note: answering yes will not necessarily bar you from volunteering)
YesNo

2. Have you ever been held, detained, taken into custody, charged, arrested, indicted, fined, forfeited bond, cited, or convicted for a violation of any law, regulation, or ordinance? (note: answering yes will not necessarily bar you from volunteering)
YesNo

3. Are you currently under indictment, on probation, parole, or work release? (note: answering yes will not necessarily bar you from volunteering)
YesNo

4. Have you ever been investigated by the Department of Social and Health Services, including, but not limited to, Child Protective Services, or a similar department or agency in any other state or jurisdiction? (note: an investigation will not necessarily bar you from volunteering)
YesNo

Explanation of any "Yes" answers

Medical
Have you been vaccinated for COVID-19?
YesNo Date of last vaccination:
I have had my childhood vaccinations for the following (check all that apply):
Measles, Mumps, RubellaPertussis (whooping cough)Chicken Pox
I have had a tetanus vaccination.
YesNo
Date of last tetanus shot

Do you get a flu shot every year?
YesNo
Do you have a physical or medical condition that would impact your ability to do this job? (i.e. bending, moving quickly, sitting on the floor, lifting chairs, tables, hearing loss, eyesight limitations)
YesNo
If yes, please explain.

If yes, what can be done to accomodate your limitation?

Please list any other medical conditions you feel we should be made aware of:

References
Please list two references who are not related to you or each other, along with their phone numbers and email addresses:
Name:

Phone:

Email:

Name:

Phone:

Email:

Emergency Contact
Name:

Relationship:

Phone:

Volunteer Application Statement
In connection with this request, I hereby authorize all corporations, former employers, educational institutions, law enforcement agencies, city, state, county, and federal courts, military services and persons to release information they may have about me to the person or company with which this form has been filed or their agent, OneLife Community Church. This releases the aforesaid parties from any liability and responsibility for collecting any information.
The information contained in this application is correct to the best of my knowledge. I authorize any references listed in this application to give OneLife Community Church any information they may have regarding my character and fitness, and I release all such references from liability for any damage that may result from furnishing such evaluations to OneLife. By signing this, I also authorize OneLife Community Church to conduct a background check verifying the information in this application regarding criminal convictions. Should my application be accepted, I agree to be bound by the Bylaws of OneLife Community Church and to refrain from unscriptural conduct in the performance of my services on behalf of OneLife.

Applicant's Name:

Other Names Used:

Parent or Guardian if under 18:

You will be asked to sign and date a printed copy of this form when you arrive at OneLife Tutoring for the first time. If you are under the age of 18, your parent or guardian will need to sign and date it as well.

Background Check
Applicant’s Driver’s License Number:

I would like a copy of my background check
YesNo