Apply to Volunteer to Help Charlotte Youth

Date

Name

First

Last

Address

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Gender

Home Phone

Cell Phone

Work Phone

Email

Best Form of Contact

Driver's License Number

References

Please list up to three persons familiar with your character.

All information will be treated confidentially and will only be used in the application, enrollment and/or matching

Reference One

Please add your reference name, relationship, address, and phone number.

Please list any arrests, convictions and recent traffic violations.

All volunteers are required to pass a background check as per the state of North Carolina.

Have you ever been convicted of a felony?

If so, please explain:

Complete if you would like to be a
RoleModel (mentor) to a young person.

Volunteer Options

Mentoring Age

Mentoring Gender

Upload Employment Resume

Captcha

Name

This field is for validation purposes and should be left unchanged.