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Apply: Board of Directors
Our Work
Community Impact
ALICE in Western Kentucky
Bridges Out of Poverty Training
Promoting Academics & Leadership in Schools (PALS)
Resource Guides
Retired United
Impact Areas
Impact Opportunity
Partner Agencies
Campaign
Events
Battle of the Barristers
BIG Bad Wolf 5k
Bourbon United Gala
Power of the Purse
Project United
Small Business Blitz
Stuff the Bus
Victory Celebration
Live United Awards
Funding
EFSP
Impact Partnerships
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Home
PALS Application
Home
PALS Application
Are you 18 and over?
Yes
No
Sorry! You are not old enough to participate in this program.
Please apply to be a PALS mentor when you turn 18.
Date of Birth
Date of Birth
Contact Information
Name
Company or Employment Status
Email
Phone
Address
City
State
- Select -
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Demographic Information
Gender Identity
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Racial and Ethnic Identity
American Indian or Alaska Native
Asian
Black or African American
Hispanic, Latino, Spanish Origin
Middle Eastern or North African
Multiethnic
Native Hawaiian or Pacific Islander
White
Another Identity
The United Way of Western Kentucky uses demographic information for the sole purpose of evaluating it's efforts towards diversity, equity and inclusion in our local community.
If you choose to participate, please select how you describe yourself. You may choose multiple options.
Can you speak a language other than English?
Yes
No
Unsure
PALS Service
Please select the statement best describes your volunteer service.
I am new to the PALS program.
I was a PALS volunteer in the past, but I'd like to return to the program.
I'm a current PALS volunteer.
If you are a current PALS volunteer, please enter your student's name.
Select School Preference
First Choice
Ballard Elementary
Tuesdays @11:25 AM
Clark Elementary
Fridays @ 7:45 AM
Concord Elementary
Various times throughout the week
Heath Elementary
Various times throughout the week
Hendron-Lone Oak Elementary
Tuesdays @ 8 AM
Heath Middle
TBD
Jonathan Elementary
TBD
Lone Oak Elementary
Tuesdays @ 8 AM
Lone Oak Intermediate
TBD
Lone Oak Middle
TBD
McCracken County High School
TBD
McNabb Elementary
Tuesdays @ Student's Lunch
Morgan Elementary
Tuesdays @ Student's Lunch
Paducah Middle
Thursdays @ Student's Lunch
Paducah Tilghman
Alternating Thursdays @ 1:20 2:15 PM
Reidland Elementary
Tuesdays @ Student's Lunch
Reidland Intermediate
Wednesdays: 4th grade at 8:30 AM or 5th grade at 9:30 AM
Reidland Middle
TBD
Orientation Session
Please select one training option.
Friday, August 14, 10:30-11:00 AM
via Microsoft Teams
Thursday, August 20, 12-12:30 PM
via Microsoft Teams
Check each box below and sign this agreement
I understand that contact and activities with my student outside of his or her school or formal program activities is not covered by the liability insurance of the Ballard County School District, the Paducah Independent School District, the McCracken County School District, or the United Way of Western Kentucky. Neither my student’s school nor United Way will have any liability for any loss, damage, or injury arising out of such contact or activity with my student.
I understand that the PALS Program is not obligated to provide a reason for its decision in accepting or not accepting me as a volunteer.
I commit to keeping personal and educational information about my student confidential.
I commit to reporting to school staff or United Way staff any information about my student that suggests that student or others may be in danger. I will adhere to mandatory reporting laws pursuant to Kentucky Revised Statue (KRS) 620.
I confirm that I have never been accused, arrested, charged, or convicted of child abuse or molestation.
I confirm that I have never been convicted of a felony. (If the applicant has been convicted of a felony, then the applicant may be considered only after a period of seven (7) years has elapsed since completion of the sentence, during which time the felon has demonstrated good behavior and an appropriate and corrective attitude regarding past behaviors.)
I confirm that I am not a user of illicit drugs.
I confirm that I am not currently in treatment for substance abuse.
I consent to any and all background and other investigations by the school system and/or the United Way as are considered prudent by that entity to determine whether I may serve as a PALS volunteer. Such investigations may include checks for accusations, arrests, charges, or convictions pertaining to child abuse or molestation. I further consent to the United Way’s use of the information gleaned from background checks or other investigations in determining whether I may serve as a PALS volunteer..
I commit to being a reliable volunteer and communicating my absences to the PALS coordinator. I will not miss more than five (5) PALS sessions per school year (September - April).
I commit to providing positive, structured, and consistent attention to my student.
I agree to allow the PALS Program to use any photographic image of me taken while participating in the mentoring program. These images may be used in promotions or other related marketing materials.
I commit to being paired with a student for at least one school year (September - April).
By signing below, I attest to the truthfulness of all information listed on this application and agree to all the above terms and conditions.
Sign above
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