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Application to Volunteer for 10,000 Degrees Academic Success
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12 Characters
1 Uppercase letter
1 Lowercase letter
1 Number
1 Special character
First Name
Last Name
Email
Application
Preferred Region
No preference
Novato
San Rafael
Sausalito/Marin City
Shoreline/West Marin
You may choose more than one.
Preferred Grade Level
No preference
Elementary (TK - 2)
Elementary (3 - 5)
Middle School (6 - 8)
High School (9 - 12)
You may chose more than one.
Preferred Subject Area
No preference
Literacy
Math
Science
College/Scholarship Essay Support
Occasional opportunities to volunteer at high school workshops (1-4 hours)
You may choose more than one.
Preferred Day(s) of Week
No preference
Monday
Tuesday
Wednesday
Thursday
Friday
You may choose more than one.
Preferred Time of Day
No preference/depends on the day
Morning
Afternoon (ends by 3:00/3:30 pm)
After school
You may choose more than one.
Languages Spoken & Proficiency
Language Spoken
Language Proficiency
Fingerprint Processing Fee and TB Testing
I am willing to cover the cost of fingerprint screening (Approx. $25)
I am unable to cover these costs; I would like to speak with 10,000 Degrees staff about payment options
Why are you interested in volunteering with 10,000 Degrees Academic Success?
Do you have any prior volunteer experience?
Yes
No
If yes, please specify any experience with youth or education.
Do you have any experience working in a culturally/socioeconomically diverse environment?
Yes
No
If yes, please describe
Do you have a felony conviction?
Yes
No
Please explain.
Contact Information
Date of Birth
Mobile Number
Home Phone Number
Mailing Street Address
Mailing City
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Mailing Zip Code
Employer
Emergency Contact
Emergency Contact Full Name
Emergency Contact Phone
How did you hear about 10,000 Degrees Academic Success?(Please click all that apply)
10,000 Degrees' website
Referral from friend/other volunteer
Other volunteer websites
Referral from teacher/school staff
Newspaper/flyer/other print media
Social media
Other
Whom can we thank for referring you?
Please specify what other volunteer websites:
Please upload a headshot here that we will use for your 10,000 Degrees Lanyard/ID Badge.
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