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2016-2017 Student Application
Student application
Graduation Year (June 01 and Year)
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As a Volunteer, you can help fellow students follow their Dreams. Please share your time, skills, or interest with other students. The gift will help other students develop positive attitudes toward learning and motivate them to achieve their potential. On the form below, please indicate how you are willing to help. We have provided a list to give you some ideas. We welcome your suggestions. Once the application is received, the volunteer coordinator will contact you for future involvement.
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Student's Last Name
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Student's First Name
Your answer
Parent/Guardian Name
Your answer
Cell or Home Phone
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Email Address ( this will be used to notify you of placement)
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I am available:
Days I am able to commit to volunteering
Required
INTERESTS (Please check all that Interest You)
Required
Parent Signature and Parent Phone Number (parent to provide for permission purposes)
Your answer
Please do not write below (FOR OFFICE USE ONLY)
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Teacher recommendations:
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Teacher Signature
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Volunteer Director's Signature
Your answer
Staff Placement Days and Times
Your answer
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