Volunteer Agreement Please fill out all information on this form. Name* Mr.Mrs.MissMs.Dr.Prof.Rev.Mx. Prefix First Last Preferred Name or Nickname First Cell Phone Number*WITS will use this number to send updates about programming. Home Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email*Please use your company email address if you volunteer as a part of a corporate group. Gender Identify: Please choose whichever option best describe you.WITS is gathering the following demographic information about volunteers to aid our efforts to recruit volunteers who reflect the diverse backgrounds of the students we serve. Female Male Non-Binary Genderqueer A gender not listed Prefer not to say Race/ Ethnicity: Please choose whichever option best describe you.WITS is gathering the following demographic information about volunteers to aid our efforts to recruit volunteers who reflect the diverse backgrounds of the students we serve. Indigenous People Black/ African Diaspora Hispanic/ Latinx/ Spanish Afro-Latinx Asian/ Asian-American South Asian Arab/ Middle Eastern Pacific Islander White Race/ ethnicity not listed Prefer not to say Have you volunteered with WITS before?* Yes No If you have volunteered with WITS before, how many years?*What corporation/ organization are you volunteering with?*If none, please select "None/Other"Affiliated organizationBairdBank of AmericaBlackRockBMO HarrisBoston Consulting GroupBrookdaleCBOEChapman and CutlerChicago Athletic AssociationChicago White SoxClareCredit SuisseDeloitteExelonFactSetGCM GrosvenorHarrison StreetJackson Financial / PPM AmericaJenner & BlockJones DayK&L GatesKirkland & EllisKPMGMcDermott Will & EmeryMorgan StanleyNorthern TrustNorth Park UniversityOrixPwCSegall Bryant & HamillWilliam BlairNone/OtherPlease select any language(s) you speak conversationally or better. Spanish Polish Arabic Tagalog Chinese ASL Other If you chose "Other" please list the language(s) here. In order to make the WITS program a success for volunteers and students, volunteers must understand and agree to the following policies and expectations:Please read the WITS Anti-Racism Commitment.Consent* I have read and understand the WITS Anti-Racist Commitment page.*Mandated Reporting: As I build a relationship with students, they may disclose sensitive information about life outside of WITS.* I agree to take my students' safety seriously and immediately report any suspicion that a student may be a victim of abuse or neglect. I understand that WITS staff will help me through the appropriate processes to report any concerns.Attendance: I understand that a consistent and 'present' volunteer has the power to significantly benefit a student's self perception.* I agree to do everything I can to attend all scheduled program times ready to engage with my student.I commit to volunteering at the frequency chosen below.* Weekly Volunteer Every Other Week Volunteer Substitute Volunteer If you are volunteering every other week, is there someone specific you would like to share a student with?Program Communication: I understand that the WITS mentor-mentee relationship will be limited to WITS time.* I will not contact students outside of WITS, exchange any contact information with students, and/or add, invite, and accept “friend” or contact requests of students on any personal social media.I will not take photos or recordings of my students or be alone with a student at any time.* I will not take photos or recordings of my students or be alone with a student at any time.WITS periodically takes photos and audio/video recordings of students and their mentors during the program for marketing, advertisement or other related lawful purposes. If you consent below you agree that: Your likeness may be used by WITS, including in any of its publications, website entries, postings on social media, and other WITS materials, without payment or any other consideration. All such materials are the property of WITS.* I consent I DO NOT consent I have read the above expectations.* I agree to adhere to WITS policies. Δ
