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2016-2017 Kewaskum School District Volunteer/Chaperone Background Application
THIS APPLICATION IS FOR ADULT VOLUNTEERS FOR THE KEWASKUM SCHOOL DISTRICT AND CHAPERONES FOR FIELD TRIPS. SEE OTHER APPLICATION FORMS ON OUR DISTRICT WEBSITE FOR STUDENTS AND STEP PROGRAM.
Kewaskum School District has an obligation to its children and community to provide a safe and secure environment for all to learn and achieve their potential. With this obligation, we need to gather the following information for all volunteer/chaperone applicants. Your replies on this application will not prohibit your consideration; however, any misrepresentation, falsification or omission of facts could result in your application to be denied for volunteering or chaperoning.
Full Legal Name
Please enter your full legal name including maiden, previous married names or alias. Answer NA if not applicable.
Last Name
Your answer
First Name
Your answer
Middle Name
Your answer
Maiden Name/Previous Married Name/s or Alias
Your answer
Gender
Date of Birth
MM
/
DD
/
YYYY
Phone Number
Your answer
Email Address
Your answer
Address
Your answer
All Previous Address's, City, State, Zip ( less than 10 years)
Your answer
Have you ever lived in another STATE? Yes or NO if YES, Please proved year and address, if NO (NA).
Your answer
Names of children/grandchildren and grades attending the district:
Your answer
Are you Volunteering for Kewaskum Schools OR Chaperoning for Field Trip/s
Volunteer or Chaperone
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