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Nelson County Public Schools - Volunteer Application
Today's Date: *
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This is a: *
I am a: *
Personal Information *
Full Legal Name: *
Last, First and Middle Initial
Your answer
Maiden name/Nickname/Aliases
Your answer
Date of Birth: *
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Birthplace *
(state OR country if outside U.S.)
Your answer
Mailing address: *
Your answer
City: *
Your answer
State *
Your answer
Zip Code *
Your answer
Email:
Your answer
Phone #: *
Your answer
Languages Spoken:
Other than English
Your answer
Special Skills
Your answer
Employer
Your answer
Names of child(ren)/student(s)
Your answer
Emergency Contact Information
Name
Your answer
Emergency Contact Information
Phone #
Your answer
Volunteer Interests and Activities: *
School(s) where I wish to volunteer: Check all that apply.
I plan to volunteer:
Check all that apply
Volunteer activities
(ex: field trip chaperone, math help, tutoring, etc.)
Your answer
Do you require any accommodations?
Check all that apply.
If "yes", what is the accommodation?
Your answer
Waiver
All information in this application is accurate to the best of my knowledge. I have received and thoroughly read the Nelson County Public Schools Volunteer Handbook. I understand the information in the handbook and I agree to comply with the guidelines set forth in the handbook. As a condition of being permitted to volunteer for Nelson County Public Schools, I freely accept and voluntarily assume the risks of personal injury or property damage that may result from my volunteer activities. I hereby agree to waive any and all claims arising out of any such injury or damage.
Your answer
Applicant Signature: *
Your answer
Date of application
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