2025-2026 Volunteer Interest Form

Name Name First Last
Preferred name
Date of Birth Date of Birth / MM / DD YYYY
Email
Preferred phone Preferred phone - ### - ### ####
Please complete if you want to receive mail) Please complete if you want to receive mail)
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Name of Employer or School (if applicable)
I am interested in the following volunteer opportunity (check all that apply):

I am interested in the following volunteer opportunity (check all that apply): Reading/Math Tutoring (Monday-Thursday, 9:00 AM - noon, 1 hr/session) Lunch time and/or Recess Assistance (11:15 AM - 12:30 PM) Breakfast support (7:15-8:15 AM) After school dismissal support (4:15-5:00 PM) Enrichment activities- arts, robotics, chess, culinary arts, music, gardening, etc. (Monday-Friday 3:15-4:25 PM) Other Other
Here's the Volunteer Schedule for 2025-2026. Please review. Please let us know if there's a specific days and time you'd like to volunteer. VOLUNTEER SCHEDULE LINK
I am interested in the following volunteer opportunity (check all that apply):

I am interested in the following volunteer opportunity (check all that apply): Athletics/Coaching (Dependent on season and coach availability - afternoons/weekends) Other Other
I am interested in the following volunteer opportunity (check all that apply):

I am interested in the following volunteer opportunity (check all that apply): Friday Liturgy of the Word (Fridays from 10:30 AM - 12:00 PM) Food repacking - Last Mile Food Rescue (Wednesdays 5:00 PM- 6:30 PM) Other Other
I am interested in the following volunteer opportunity (check all that apply):

I am interested in the following volunteer opportunity (check all that apply): Event set-up, support, and clean-up (occasional, times vary) Garden and Campus clean-up (occasional, times vary)
Tell us about your experience or familiarity working with middle school aged children and/or underserved communities.
Have you ever been charged, accused, or convicted of child abuse, neglect, or sexual abuse?

Have you ever been charged, accused, or convicted of child abuse, neglect, or sexual abuse? Yes No
Have you ever been charged, accused, or convicted of a felony?

Have you ever been charged, accused, or convicted of a felony? Yes No
I agree to complete the Archdiocese of Cincinnati SafeParish training and a background check before my involvement at Xavier Jesuit Academy. If yes, here's the link for the instructions to start that process.

I agree to complete the Archdiocese of Cincinnati SafeParish training and a background check before my involvement at Xavier Jesuit Academy. If yes, here's the link for the instructions to start that process. Yes