APPLY TO BE A VOLUNTEER!

In order to volunteer with an elementary school program, volunteers must be at least a high school freshman. Volunteers for middle school programs must be at least a high school junior.
Background clearance paperwork may be required for volunteering students, depending upon the nature of their service hours with us. Adults 18 years or older and anyone planning to volunteer on a continuous basis will be required to complete a full clearance file with NIA, which includes a Statewide Central Register (SCR) clearance, Criminal Background Check (CBC), and fingerprint submission. This paperwork will be filled out at the NIA main office at 6614 11 Avenue, Brooklyn, NY 11219.

Name

First Name

Last Name

Age

If accepted, volunteers under 18 years old will need to provide a parent signature.

Preferred School or Volunteer Activity

Please choose one NIA after school site to volunteer for or choose "NIA Community Event" if you'd like to volunteer to help at an upcoming one.

Phone Number

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact

First Name

Last Name

Emergency Contact Phone #

(###)

###

####

Relationship to Contact

Reference # 1

Do not list a relative (name, address, phone #)

Reference # 2

Reference # 3

Please tell us a little about why you are interested in becoming an NIA Volunteer!

Ex 1: I am interested in helping instructors teach art. Ex 2: It is a requirement for my school.

Have you ever been convicted of a crime in NY State or any other jurisdiction?

Yes

If yes, explain:

All of the information listed herein is accurate to the best of my knowledge. I understand that my e-signature indicates that I have been completely truthful in providing the information recorded on this application.

Please provide your e-signature.

First Name

Last Name

NIA Community Services Network · 6614 11th Avenue, Brooklyn, NY 11219

Michael A. Bové, President · Mary Anne Cino, CEO

Phone: 718.236.5266 · Fax: 718.236.0971 · info@niabklyn.org

TERMS & CONDITIONS PRIVACY POLICY

NIA is a 501(c)(3) not-for-profit organization. Contributions are tax deductible to the full extent of the law.

Copyright © 2022 NIA Community Services Network, Inc. All Rights Reserved.