Request edit access
2016-2017 Student Application
Graduation Year (June 01 and Year)
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.
Student's Last Name
Student's First Name
Cell or Home Phone
Email Address ( this will be used to notify you of placement)
I am available:
Days I am able to commit to volunteering
INTERESTS (Please check all that Interest You)
Math Tutor K-5
Reading with a Child
Boys And Girls Club 262-334-3732
Tutoring at KMS or KHS
Day Care Volunteer
Parent Signature and Parent Phone Number (parent to provide for permission purposes)
Please do not write below (FOR OFFICE USE ONLY)
Volunteer Director's Signature
Staff Placement Days and Times
Never submit passwords through Google Forms.
This form was created inside of Kewaskum School District.
Terms of Service