23-24 Volunteer Application Please complete this form for the 23-24 school year. ALL 1st (new) year volunteers MUST attend a PARENT AND VOLUNTEER orientation before beginning to volunteer. Full Name* First Name Last Name Birth Date* 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Year Phone Number* E-mail* Instagram: @ Facebook: This is my ___ year volunteering with Friendship Circle.* 1st (New) 2nd 3rd 4th 5th 6th ALL 1st (new) year volunteers are REQUIRED to submit 2 letters of reference. All 1st (NEW) volunteers MUST submit a letter of referece: Upload the 1st one here: All 1st (NEW) volunteers MUST submit a letter of referece: Upload the 2nd one here: Grade level (2023-2024)* 7th 8th 9th 10th 11th 12th School:* If affliated with a synagogue, please write the name of synagogue: If affliated with any school clubs/ teams (sports, honor society, etc) please write the names: If your Bar/Bat Mitzvah is this year, what is the date? 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December Month 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Year Are you afflicated with a Jewish Youth group? If so, which one? Do you speak Spanish?* Yes, fluently. No Enough to have a conversation. Primary Parent/Guardian 1* First Name Last Name Primary Parent/Guardian Cell Number* Relationship to Volunteer:* Primary Parent/Guardian 1 Occupation:* Primary Parent/Guardian 1 Email:* Address* Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Primary Parent/Guardian 1 Instagram:* Primary Parent/Guardian 1 Facebook: * Parent/Guardian 2* First Name Last Name Parent/Guardian 2 Cell Phone* Parent/Guardian 2 Relationship to Volunteer:* Parent/Guardian 2 Occupation:* Parent/Guardian 2 Email: * Parent/Guardian 2 Address, if different Street Address Street Address Line 2 City State / Province Postal / Zip Code Please Select United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People's Republic of China Republic of China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Other Country Parent/Guardian 2 Instagram: Parent/Guardian 2 Facebook: Please upload a recent picture of yourself. Keep in mind this will be in the newspaper.* Which parents do you live with?* How did you hear about our program? If it was an other volunteer please write his/her name* Program Selection: Please note that programs are based on availability. We will try to accommodate you to one of your preferred choices of programs. Please indicate which programs you would like to volunteer for. You can participate in more than one!* Friends @ Home: October - May. Home visits you must include when you are available to make visits, so we can pair you up with a friend based on your availability.NO SPOTS AVAILABLE: Sunday Circle: Children's Circle, Tween Scene & Teen Scene: 2 Sundays a month: 9:30 - 12pm.NO SPOTS AVAILABLE: Kulanu Circle: Hebrew School Inclusion Program: 3 Sundays a month: 9:30- 12pm.NO SPOTS AVAILABLE: Art Circle: October - May: Mondays 4-5 PMMovement Mondays: October - May: Mondays: 5-6 PMNO SPOTS AVAILABLE: Swimming Circle: Session 1: Tuesdays 4:30-5:30 (10/23 - 12/23)Equestrian Circle: Tuesdays 4:00- 5:30 (1/9 - 3/19) MUST BE 14 YEARS OLD.NO SPOTS AVAILABLE: Swimming Circle: Session 2: Tuesdays 4:30-5:30 (4/24 - 5/24)FC Band: October - May: Wednesdays: 4-5 pmDrama Circle: October - May: Wednesdays 5- 6 pmNO SPOTS AVAILABLE: Music Circle: October - May: Thursdays 4-5 pmNO SPOTS AVAILABLE: Life Skills Around Town: October - May: Thursdays: 4-6 pmNo School Fun DaysWinter CampSummer Camp In case your choice is not available, what other programs would you like to Volunteer for instead?* If you select Friends @ Home, you MUST indicate what days/times you are availible for home visits. If you select Friends @ Home, is their a friend you would like volunteer with? Do you have a drivers license?* YesNo Are you parents able to drive you to programs?* YesNo Medical Information: Please have a parent/guardian assist you in completing this section. Any food allergies?* Reactions to medications?* Any medical circumstances?* Any Current medications?* Emergency Contact 1* First Name Last Name Emergency Contact 1 Cell Phone* Relationship to Volunteer:* Emergency Conact 2* First Name Last Name Emergency Contact 2 Cell Phone* Relationship to Voluneer:* By typing my name below, I understand that the Friendship Circle of Miami, Inc, including without limitation, any of its directors, teachers, employees, or agents, and including any volunteer, shall not be liable to any party for injury or damage, whether from acts of negligence or otherwise, in any way attributable to or in connection with such activities or field trips. Name of Parent/Guardian:* Name of Volunteer:* I permit my child's photos - without any identifying information - to be used for publicity purposes by The Friendship Circle and its partners, as it relates to Friendship Circle activities.* YesNo I give permission for my child(ren) to participate in off-site field trips as scheduled. You will be advised of such field trips in advance.* YesNo The Friendship Circle provides very special and unique opportunities for volunteers, special friends, and both sets of families to enrich the lives of each other. In doing so, some participants may encounter new and sometimes challenging situations. Thus, it is imperative to set expectations in the beginning so that volunteers, special friends, and parents understand what they can expect. Please take a moment to read over and check the boxes below each guideline that establishes safety and promotes friendship based on mutual respect and personal well-being for everyone involved in our program. You/your child may not be involved in a specific program referenced; however you may be involved at some point during the year so please acknowledge by checking every statement. I understand that participation in this program is entirely voluntary and requires participants to abide by applicable rules and standards of conduct, to use their best judgment and sense of responsibility when volunteering in all program and events, and to serve as a role model to our special friends and other volunteers.* ParentVolunteer I understand that, if I choose to give out personal phone number or social media to a participant, Friendship Circle is NOT responsible for communication outside of Friendship Circle.* ParentVolunteer I understand that, as a result of being a Friendship Circle volunteer, I will be building bonds with special friends who will be counting on me to be present consistently. VOLUNTEER ATTENDANCE MUST BE A PRIORITY.* ParentVolunteer I understand that as a volunteer with this program, the use of a phone or other electronic devices during programs does not promote healthy friendships. A cell phone should only be used in case of emergency.* ParentVolunteer I understand that participation in Friendship Circle activities involves a certain degree of risk and can be physically, mentally, and emotionally demanding. I may be exposed to biting, hitting, and scratching. I agree to take on this responsibility.* ParentVolunteer I agree not to bring any alcohol, drugs, tobacco products, vaping devices, weapons, firearms, posses any illegal substances or other dangerous items to any Friendship Circle program or events.* ParentVolunteer I agree to respect the privacy of all participants of the Friendship Circle and to keep all personal information confidential.* ParentVolunteer In the event that I am unable to volunteer during my scheduled time, I will contact the FC Coordinator AT LEAST 48 HOURS in advance, barring illness or family emergency. In the case of the Friends @ Home program, I will try to find another day to substitute, and I will notify the parents of my special friend AT LEAST 24 HOURS in advance.* ParentVolunteer I agree to dress appropriately: no tank tops, no ripped jeans, shorts MUST be fingertip length on thigh, and wear sneakers.* ParentVolunteer I agree to represent the Friendship Circle of Miami to the best of my abilities.* ParentVolunteer Please have your parent or guardian click here to fill out the release form for a volunteer under the age of 18. Submit Should be Empty: This page uses TLS encryption to keep your data secure.