GENuine Connections Teen Registration Form

GENuine Connections New Youth Volunteer Application 2023-2024
Thank you for your interest in the GENuine Connections.

Application Process:
- Complete this application. Any questions that are not pertinent to you may be left blank.
- Register and attend your zoom orientation
Please note: if you have participated as a Teen Intern in the past, you do not need to complete this application.

Contact us at GENuineconnections@dorotusa.org with any questions.
Name

First NameLast Name
E-mail
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number
Format: (000) 000-0000.
Birth Date

MonthDayYear
Home phone
Gender
What pronouns do you use? (Choose all that apply)
Pronouns (if not listed above)
Please describe yourself. Check all that apply: (For demographic purposes only, please select all that apply)
If Other, please specify:
Do you consider yourself to be...? (For demographic purpose only, please select all that apply)
If Other, please specify:
I speak the following languages in addition to English. Choose ALL that apply:
Other Language(s) Spoken:
Name of School you attend
Type of School
Grade
*We only accept 9th - 12th grade, High School Students to the program.
Are you an alum of any of these DOROT programs? If so – check all that apply
Parent or Guardian Information
Parent or Guardian Name

First NameLast Name
E-mail
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number
Format: (000) 000-0000.
Employer
Occupation
Business Phone Number
Format: (000) 000-0000.
Home Phone Number
Format: (000) 000-0000.
Parent or Guardian 2 Name

First NameLast Name
Email
example@example.com
Address (if different from above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number

Area CodePhone Number
Employer
Occupation
Business Phone Number

Area CodePhone Number
Home Phone Number

Area CodePhone Number
I heard about GENuine Connections through

Other
What motivates you to apply for GENuine Connections? *
Next Steps:
Once you submit this form, you will be redirected to register for a Zoom Orientation. Please choose a date that works for you!

Contact genuineconnections@dorotusa.org with any questions.

Thank you again for your interest in GENuine Connection.
Should be Empty:

GENuine Connections New Youth Volunteer Application 2023-2024

Next Steps: