Yewths ROC

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Youth Volunteer Application

 

Eligibility Requirements

Before completing this application form, please read the following eligibility requirements and details:

• Must be 12 years of age or older to apply
• If under 15, must have a parent or chaperone accompany you on outreach trip
• Must have prior involvement with YEWTHS ROC Program
• Evidence of community or civic involvement
• Leadership skills
• Two Letters of Recommendation (including all contact information)
• Be prepared for a personal interview with ROC staff members
• Applicants must pay for their expenses associated with outreach trip

You must submit this completed application form and all supplementary sheets to ROC Wheels by October 1, 2010.  Late applications will not be accepted.  Selection will be based upon the essay, biography, and ROC volunteer history of applicant.  Only 24 applicants will be selected to go on the Jamaica Spring Break Expedition that will take place in March of 2011.  Semi-finalist will be notified to set up a personal interview by October 6, 2010.  All finalists will be notified by October 15, 2010.      

Essays

Please prepare the following documents with your name in the upper right-hand corner.

1. A brief autobiography, no longer than one page, introducing yourself (this will be used to introduce you to other students and volunteers on outreach trip).

2. A detailed statement of intent, no longer than 2 pages, describing:

• Your reasons for applying to be a YEWTHS ROC Volunteer
• Your strengths and what you hope to offer the ROC Team and the children affected by disabilities and their families (ex: your talents, gifts, character traits, etc.)
• What you hope to gain from this YEWTHS ROC Volunteer experience

Letters of Recommendation

Applicants should have two academic instructors or appropriate mentors/employers/supervisors/pastors/etc. complete a letter of recommendation. You should inform the professionals writing the recommendation that they are writing a letter for the purpose of applying for the YEWTHS ROC Jamaica Spring Break Expedition.

ROC Wheels.  301 Gallatin Park Dr.  Bozeman, Montana 59715.  www.RocWheels.org.  406.556.8065. 

Personal Information

 

Date of Application: __________________________________________________

Outreach Destination: ________________________________________________

Name: _______________________________________________________________________
            Last                                         First                     Middle

Address: _____________________________________________________________________

Telephone Number: _______________________________    E-mail: _______________________________
What is the best way to contact you? Phone_____ email_____ Other _______________

Passport #: _________________________________________

Date of Birth: ________________     Citizenship: _____________

Male ____  Female ____    School Attending: _________________    T-Shirt Size ________

 

Qualifications

 

1. How did you become familiar with ROC Wheels, Inc.?
   
   

____________________________________________________________________________

2. Do you have any foreign language skills?  What language(s)?

 

___________________________________________________________________________

3. Academic achievements, volunteer experience and extracurricular activities:

 

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

4. Have you ever been on an international volunteer/missionary trip before?  Where?

 

____________________________________________________________________________

5. If so, what was your experience like?

 

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

6. Do you know of any reason that you may have difficulty functioning in a foreign country?

 

_______________________________________________________________________________

7.  Have you ever been convicted of a felony? (This is solely for the ROC Wheels, Inc. staff)

 __________________________________________________________________________

8.  Do you have any dietary restrictions?  If so, please specify. 

______________________________________________________________________________

9.  ROC Wheels is a Christian faith-based organization. Would you like to participate in any gatherings for prayer, music, or worship?  Yes ___     No ___

10.  Will a parent or chaperone be going with you?  Yes ___     No ___

• Name of parent or chaperone (this individual must submit a volunteer application):

 

            ________________________________

11.   Indemnity:
I/We do hereby agree to pay for any medical expenses incurred by said person(s) and to reimburse ROC Wheels, Inc. for any expenses incurred by it with respect to such expenses. I/We herby agree that I will not hold ROC Wheels, Inc., its staff, agents and volunteer responsible for any illness, injury, damage or loss incurred by said person(s) during the course of involvement with ROC Wheels’ YEWTHS ROC Program.

Signature of Applicant:_________________________________________

Date:____/____/____

If applicant is under 18 years of age, signature(s) of Parents/ Guardian is also required.

Signature(s) of Parents or Guardian:_________________________________

Date:____/____/____

Medical Information

1. Is there any medical or physical reason why you would have to restrict yourself from strenuous activity?

 __________________________________________________________________

 

2. Do you have any allergies to food, medicine or the environment?

__________________________________________________________________

Emergency Contact

Name: _____________________________  Relationship: __________________

 

Address: __________________________________________________________

 

Phone number: ____________________       E-mail: _______________________

 

 

 

_________________________________      Date: __________________
Your signature

 

Deadline:  You must submit this completed application form and all supplementary sheets to ROC Wheels by October 1, 2010.  Late applications will not be accepted. 

Please mail or e-mail the completed application to:

ROC Wheels Inc.,
301 Gallatin Park Dr.
Bozeman, Montana 59715
holly@rocwheels.org

 

 

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Click button to go to PayPal secure site for credit card donations. ROCWheel'ss tax ID number is 20-0402658

ROC Wheels, 301 Gallatin Park Dr , Bozeman, Montana 59715 www.RocWheels.org Andrew Babcock, Executive Director, Andrew@ROCWheels.org Phone/Fax #: 406.556.8065   ROC Wheels is a 501 (c ) (3) Non-profit Organization