VOLUNTEER APPLICATION This application is to be completed by all volunteer applicants. The information will help to ensure a safe and secure working environment. PERSONAL INFORMATION 1. Address 2. Social Security Number: 3. Driver’s License Number: 4. Marital Status Single Engaged Married Divorced Widowed None EMERGENCY CONTACT 5. Name 6. Relationship: 7. Phone: 8. Email: MINISTRY (if applicable) 9. Name: 10. Address: 11. Contact: 12. Area of Service: Please submit your most recent Resume or LinkedIn address in addition to an essay (3) references along with the essay 13. Write a brief (200 word essay) about one of the following topics: 1. A significant event in your life that has impacted you to love special needs children or 2. Your expectations of working with children and a community with a different cultural background or 3. A time when you led a person to love or appreciate a child with a disability 14. SCSP has a rehabilitation center housing vulnerable children for special needs education, but it also does community outreach in the rural areas of Uganda to empower parents and community as well as sensitizing them to issues around living with disabilities In order to understand you better, let us know your areas of interest whilst in Uganda. Please check all that apply: Medical/ Health/Rehabilitation Computer/IT skills/Online skills Teaching/Education Grant Writing/Fundraising Counseling/ Social Emotional Awareness Banking and Micro Finance Arts and crafts/ Vocational skills/Tailoring Project Sustainability/ Micro Projects Agri-Farming/Piggeries Music/Dance Financial Literacy/Accounting Social Media Content Strategist and Promoter SPECIAL CHILDREN EXPERIENCE 15. What level of experience do you have working with special needs children? I have never worked with special needs children I have worked with special needs children in limited capacity I have worked extensively or I have training and experience in special education I have been a part of a Ministry that assists special needs children None 16. What level of contact would you like to have with the children? I prefer to work alone on delegated tasks I am comfortable with direct contact with children I am best with offering group or cooperative support to the overall school I am energized by team work with parents and staff I am unsure. This is my first time None 17. Which age group are you best matched to assist? 0-2 3-5 6-10 11-15 16 and up None 18. What knowledge do you have about issues concerning child abuse? None Minimal Very aware. I have worked with survivors I am a survivor of child abuse I have been involved with Ministry that services child abuse survivors None 19. How long do you plan to volunteer? Days Weeks Months Unspecified None ABOUT YOU 20. Do you have any special day (e.g. birthday, anniversary, etc) that we can celebrate with you during your stay with us? Yes No None 21. Do you have any physical handicaps or conditions preventing you from performing certain types of activities relating to children work? Yes No None 22. Do you have any special talents that you would like to share at the school? Yes No None 23. Uganda is a popular tourist spot for Safari thus it is our practice to schedule a Wild Life Tour toward the end of your stay. Note: This is a prepaid event. Therefore, we must gauge interest in order to make reservations. Do you have interest in this event? Yes No None Time's up
