ACES 2016
(a program of the Institute on Disabilities at Temple University)
Volunteer Application
Please see “Job Descriptions” documents for details about these positions.
Aide
Aides are beginner volunteers. They assist with the daily operations of ACES. This may include
assisting with transportation, preparing materials, coordinating activities (under direction of
therapists), and helping participants take part in ACES. Aides will have the opportunity to learn
about disability-related issues, to be a communication partner, to learn about speechgenerating devices, and to have fun!
Counselor
Counselors are more-skilled volunteers. They will support 1-2 specific participants during
ACES by supporting learning during class activities, reinforcing content, answering questions,
and helping complete assignments. They will learn basic use and support for 1-2 specific
communication devices. Counselors should commit to attending 1-3 evening events and may
plan or lead social activities.
Intern / Staff SLP
Interns and staff may provide professional speech-language pathology or assistive technology
services during ACES. They plan for and lead therapy activities and may teach part or all of a
class. They will support advanced device use and communication or empowerment topics.
Planning and preparation time are required.
Please see “Job Descriptions” documents for details about these positions.
All staff and volunteers should provide their own transportation to and from Temple University
campus from July 18 through 29, 2016. Meals may be provided while volunteering during
ACES classes and social activities.
Please type or print
CONTACT:
Name:
Position (Aide, Counselor, Intern, Staff SLP):
Date of Birth:
Gender:
Permanent Address:
E-mail:
Phone Number:
Alternate:
Certification (CCC-SLP, ATP, CPR, First Aid, etc.):
EMERGENCY CONTACT:
Name:
Relationship:
Phone Number:
Address:
EDUCATION:
Undergraduate:
Major / Minor:
Year of (Anticipated) Graduation:
Graduate:
Major / Minor:
Year of (Anticipated) Graduation:
Other:
WORK EXPERIENCE:
List relevant past work experience (Provide names and phone numbers of people to
contact)
Company/Organization:
Position:
Dates of Employment:
Contact Person:
Phone Number:
Company/Organization:
Position:
Dates of Employment:
Contact Person:
Phone Number:
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PERSONAL INFORMATION:
Describe your experience with people with disabilities: Note specialized training
(e.g., behavior management, communication training, provide physical assistance, etc.)
Why do want to volunteer at ACES? What do you hope to gain from the
experience? What amount of time are you able to commit to during the program?
Describe Yourself: (Strengths, weaknesses, interests, ability to work with others, etc.)
Have you been convicted of a criminal offense? (If yes, please explain)
Have you ever had a Criminal Background Check? (If yes, forward copy of results)
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Self-paced instructions and supports will be provided to learn about devices, as needed.
Hands-on device training is planned for July 15-17, 2016 (prior to participants’ arrival).
Please detail your availability between July 18th and 29th.
ADDITIONAL INFORMATION:
Character references (2) with name, address, and phone number may be requested.
Applicants may also be asked to submit a resume or curriculum vitae (CV).
Other information relevant to your application to participate in ACES:
I have read and understand the Job Description for this position. I am available
during the required time periods, and believe I am capable of completing all required
tasks.
I understand that completing this form does not guarantee that I will be selected
to volunteer at ACES. I realize that volunteers will be chosen based on qualifications
as well as the number of ACES participants. I acknowledge that all information
provided is true.
Signature of applicant:
Application Date:
Please return to:
Russell Goldstein - rgoldstein@temple.edu
Augmentative Communication Empowerment Supports (ACES)
Institute on Disabilities at Temple University, College of Education
1755 N 13th St, Student Center, Room 411S
Philadelphia, PA 19122
215-913-0976 (voice) 215-204-5405 (TTY) Fax: 215- 204-6336
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