Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I identify as *

Female

Male

Other

Choose not to answer

I identify as *

White

Black/African American

Asian

Pacific Islander

Indigenous

Latinx

Hispanic

Person of Color

Other

Choose not to answer

Self-Employed *

Yes

No

Does your employer have a matched-giving program? *

Many employers sponsor matching gift programs and will match any charitable contributions or volunteer hours made by their employees, retirees, and/or employees’ spouses. Matching gifts means a greater impact for CIE.

Yes, my employer has a giving program.

No, my employer does not have a giving program.

Maybe, I do not know if my employer has a giving program.

Why are you interested in becoming a volunteer for our mentor program? *

I have read CIE's' Volunteer Agreement. I understand and agree to CIE's' Volunteer Agreement and will abide by all subsequent policies and procedures of the volunteer program.

I understand and agree to CIE's Volunteer Agreement and will abide by all subsequent policies and procedures of the volunteer program.

I have read CIE's' Position Description *

I have read and agree to CIE's Position Description and will abide by all subsequent policies and procedures of the description.

I have read CIE's' Volunteer Agreement. I understand and agree to CIE's' Volunteer Agreement and will abide by all subsequent policies and procedures of the volunteer program. *

I understand and agree to CIE's Volunteer Agreement and will abide by all subsequent policies and procedures of the volunteer program.