UVA Facilitator Sign-Up Sheet

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Survey to indicate your availability to participate in Rise Together this semester. If you have any questions or would like more information before signing up, please email Bryan Christ (brc4cb) or Brian Kagel (btk8dv).

Name *

Email *

Phone Number *

What times are you available to volunteer with Rise Together (please check all available times)? *Please budget for 15-20 minutes of travel time before and after the session on days we travel to the school site. We provide transportation to and from school sites for mentoring sessions. *

Albemarle County Community Public Charter Middle School: Tuesdays 1:30-2:30

Charlottesville High School: Thursdays 9:05-9:59

Charlottesville High School: Thursdays 10:03-10:51

Charlottesville High School: Thursdays 2:05-2:53

Charlottesville High School: Thursdays 2:57-3:50

Walton Middle School: Fridays 10:46-12:47

Walton Middle School: Fridays 12:45-2:41

None of these times work for me

Required

Would you be willing to volunteer at more than one site each week this semester? If so, which sites? (not expected but welcomed)

Do you have a car that you are willing to transport other UVA Facilitators in for mentoring sessions? (Madison House will reimburse your gas at the end of the semester at $.25 per mile) *

Yes

*FOR RETURNING MEMBERS ONLY* Are you interested in joining our leadership team this semester? If so, what position(s) are you interested in? Examples include serving as a team leader, fundraiser, recruiter, grant-writer, researcher, website/social media coordinator, etc.

If you are available to participate in more than one session, which one is your top choice?

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