tss volunteer form

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The Samuel School Volunteer Enrollment Form

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! Please return this signed form and necessary clearances to the School office!

NAME ________________________________________ DATE ___________________________________ ADDRESS _______________________________________________________________________________ CITY ____________________ STATE ________________

ZIP _______________________________

PHONE (DAY) ____________________________ PHONE (EVENING) ____________________________ EMAIL__________________________________DATE OF BIRTH (MM/DD/YY) ____________________ EMERGENCY CONTACT _______________________________ PHONE _________________________ EDUCATIONAL BACKGROUND___________________________________________________________ CURRENT / FORMER OCCUPATION______________________________________________________ OTHER VOLUNTEER EXPERIENCES _____________________________________________________ HOBBIES / INTERESTS / SKILLS__________________________________________________________ VOLUNTEER OPPORTUNITIES AT TSS (Check all areas of interest) ___ Classroom Assistant

___ Classroom Reader

___ Drivers

___ Library Aide

___ Prayground

___ Fundraisers

___ Office Assistant

___ Music

___ Lunch helper

___ Tutor

___ Computer Aide

___ Recess

___ Art

___ Special Events

___ Theater

___ Dismissal

___ Marketing

___ Prayer partner

AVAILABILITY ____ Flexible

____ Weekdays

____ Evenings

____ Weekends

Best days and times _________________________________________________________________ Days/Times NOT Available __________________________________________________________ How did you learn of The Samuel School?_______________________________________________ MANDATED REPORTING

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I have read the mandated reporter information provided by The Samuel School. In signing this form, I affirm that the information I have given is true and correct.

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Signature: ____________________________________________ Date: ____________________.