Tutor and Mentor Application Tutor and Mentor Application Form "*" indicates required fields Personal InformationYour Name* First Last Gender Male Female Your Birthdate* MM slash DD slash YYYY Age* Contact InformationYour Address* Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Cell Phone*Home PhoneYour Email Address* Have you ever been convicted of a felony?* Yes No Have you ever been accused of harming a child?* Yes No How will your experience and interests contribute to Muindi Foundation's mission?* Have you ever been a mentor before?* Yes No Have you ever been a tutor before?* Yes No Yes If yes please explain* Yes If yes please explain* Currently Working? No Yes, Full-Time Yes, Part-Time Current Employer* How did you hear about Muindi Foundation* What Languages are you fluent in?* Are you available a tutor/mentor a child minimum of 8 hours a month?* What days and times are you available to tutor/mentor a child? (Example M & W 4-5pm)* Volunteer Guidelines and AcknowledgmentWelcome to Muindi Foundation. Our volunteers are very important to us, and are critical to our mission. To ensure that everyone has a rewarding and safe volunteer experience, please review and acknowledge receipt of these rules. It is our belief that all clients coming to Muindi Foundation should be treated politely and with respect. We need you to share this belief as a valued volunteer of Muindi Foundation. Muindi Foundation operates a drug and alcohol-free environment. Smoking isalso always prohibited in the premises including the parking lots.Our staff will give you direction, so please complete duties as assigned. Ask for help, as needed.We want a safe and healthy environment for everyone, so please be aware of the following: a. You are expected to exercise caution in all activities including the use of knives, lifting, opening cans and jars, dealing with hot items, walking in wet/slippery areas, etc. Report to management immediately any unsafe practice or condition you notice. b. Volunteers must wear closed-toe, non-skid shoes. If you are working in the kitchen, please have hair cover (baseball caps, hair nets, etc.,) at all times. c. Wash your hands often, and always wear clean gloves. Replace gloves between tasks, after breaks, returning from the restroom, or whenever they have been in contact with harmful organisms, e.g., after coughing. d. Use proper lifting techniques, using your legs to push upwards, keeping your back straight and body balanced. Solicit the help of another person to lift objects over 20 pounds or any weight which is potentially hazardous to you. Please always ask for help if you need assistance. e. If an injury occurs to you or someone else, report it immediately to a staff member. f. Leave all your personal belongings, purses, backpacks, computers, etc., in your vehicle or at home. Muindi Foundation cannot assume any responsibility for damage to or loss of the personal property of volunteers. g. Muindi Foundation prohibits all types of harassment. All such harassment will not be tolerated. It is critical that you let management know immediately if you feel that this is happening to you. h. Please dress appropriately. Any clothing apparel with potentially offensive language/pictures is not permitted. i. Volunteers must always act in a professional manner while at Muindi Foundation. Foul/rude language and unprofessional conduct is prohibited.If you need to leave before the end of a shift, please advise a staff member.All Muindi Foundation property including supplies, materials, and equipment, must be used for its intended purpose. Unless authorized by a staff member, volunteers are not authorized to remove or otherwise misuse such property.Cell phones and any electronic devices must be used with discretion. Management may ask that you stop or refrain totally from use of such equipment as it deems appropriate. I understand and agree to abide by Muindi Foundation guidelines while I am a volunteer for any Muindi Foundation activity by my signature below, I release Muindi Foundation without limitations from any liabilities, damages, claims, legal claims, and fees.CommentsThis field is for validation purposes and should be left unchanged. Buy & Donate Directly on Amazon Smile! Learn More About Amazon Smile