Vibha Pair2Care Mentor Signup

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

An exciting opportunity to mentor a child in Mumbai India. We are looking for volunteers who will become a ‘big brother/sister’ to a kid from less privileged backgrounds, and serve as a mentor. We need a six month commitment with obviously the ability to add on as we review at the end of six months. We are looking for volunteers who are empathetic, disciplined, and have good social and communications skills. If you have any questions, please contact us at youth@dallas.vibha.org

Volunteer Full Name *

Volunteer Vibha Action Center *

Volunteer Email *

Volunteer Phone Number *

Parent Name (Enter N/A if Volunteer is above 18) *

Parent Email (Enter N/A if Volunteer is above 18) *

Parent Phone Number (Enter N/A if Volunteer is above 18) *

What is the volunteer's level of proficiency in Hindi language? *

Can understand, but can't speak

Can understand and speak basic Hindi

Cannot understand or speak

What is the volunteer's level of proficiency in Gujarati language? *

Can understand, but can't speak

Can understand and speak basic Gujarati

Cannot understand or speak

Additional comments / constraints

Consent And Release Form: Vibha’s Pair To Care initiative is an exciting opportunity to mentor a child from one of our very own Vibha supported projects - CORP in Mumbai India. By signing this form, I agree that my child will serve as a volunteer tutor at Vibha. I give you permission to use my child's photo/video from tutoring sessions for promotional purposes (e.g. flyers for Vibha events, promotional videos). I authorize and consent to Vibha volunteers to communicate with my child electronically, including via social media, text, email, phone and video conferencing tools (e.g. Zoom) in accordance with the program. I understand that if my child is below the age of 18, an adult will be present in the vicinity to monitor the session interaction. If I choose to rescind my authorization and consent provided herein, I agree that I will inform Vibha in writing and that my rescission will not take effect until it is acknowledged by Vibha. I understand, however, that it may not be possible to recall any work, photos or videos that have been published already. I further agree that my child will interact with the mentee kids in an appropriate way through audio/video calls and messages and any inappropriate behavior will lead to immediate removal from this program. I further understand that mentee kids and/or their parents/guardians may use any language & behavior that we don't have control on. I further hereby hold harmless, release and forever discharge Vibha and its volunteers, agents, licensees and legal representatives from, and shall indemnify them against, all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators or any other person(s) acting on my behalf or on behalf of my estate have or may have by reason of my Child’s participation in the program(s) and through my authorization, consent and release herein. I have read this Consent and Release Form, I fully understand it, and I voluntarily agree to be bound by its terms. I represent and certify that I am the parent or legal guardian of the minor. *

I have read this Consent and Release Form, I fully understand it, and I voluntarily agree to be bound by its terms.

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Vibha (Help Them Grow). Report Abuse

Forms