Children’s Teachers & JY Animators

Name*

Prefix First Middle Last

Gender

Male
Female

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Primary Phone*

Best number cell or landline

Additional Phone

This is an option for second phone number

Email*

Birth Date

Registered Bahá’í*

Yes
No

If yes, ID #

Which programs are you available to serve?

June 25-29 | Family Program 1
August 21-25 | Family Program 2

Are you available on other dates not listed above?

Have you served at Green Acre as a teacher or JY/Youth facilitator since 2019?*

Yes
No

When and for how long?

Children's Class and/or Junior Youth, or Youth Facilitation Experience:

Describe your experience with teaching Children's Classes and/or Junior Youth or Youth facilitation. How often? What materials do you have experience with? Please include dates if known. If you don't have experience (it is not required), please share why you would like to serve in this role.

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Do you have health insurance coverage?*

Yes
No

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Insurance Company

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Policy Number

Reference #1

Reference #1 Name

Reference #1 Primary Phone

Best number cell or landline

Reference #1 Add'l Phone

Reference #1 City, State (Province)

Reference #1 Primary Email

Reference #1 Other Email

Reference #2

Reference #2 Name

Reference #2 City, State (Province)

Reference #2 Primary Phone

Best number cell or landline

Reference #2 Add'l Phone

Reference #2 Primary Email

Reference #2 Other Email

ALL VOLUNTEERS ARE RESPONSIBLE FOR THEIR OWN MEDICAL COSTS

Do you have any medical or other conditions that might impact your ability to serve? If so, please describe:

Emergency Contact #1

Contact #1 Name

Contact #1 Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contact #1 Primary Phone

Best number cell or landline

Contact #1 Add'l Phone

Emergency Contact #2

Contact #2 Name

Contact #2 Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contact #2 Primary Phone

Best number cell or landline

Contact #2 Add'l Phone

[Please also note that the School is a smoke-free and tobacco-free campus.]

Volunteers are required to provide two references: 1) a non-family member who is personally acquainted with the applicant (provide information below) and 2) a Bahá’í serving in an administrative capacity.

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Life and Work Experience

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Describe relevant life and work experience that you could bring to your role of service here at Green Acre. Many of our volunteer roles are either in the kitchen or with hospitality so any experience with food preparation and clean up or preparing rooms for guests in your home or in a work place. In addition, feel free to list any and all skills you might be able to contribute beyond those types of activities.

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Children’s Teachers & JY Animators

Application for Teacher / JY or Youth Facilatator

Children's Class and/or Junior Youth, or Youth Facilitation Experience:

Reference #1

Reference #2

Emergency Contact #1

Emergency Contact #2

Life and Work Experience

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