Ccps Volunteer Interest Form
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1CLAYTON COUNTY PUBLIC SCHOOLS
VOLUNTEER INTEREST FORM
School ________________________ Date _______________
Name: ________________________ __________________________ ____________________
Last
First
Full Middle Name
Address: _______________________________ City: __________________ Zip ___________
Telephone #: ____________________ ______________________ _______________________
Home
Work
Cell
E-mail Address _________________________________________
Student’s Name: _________________________ Grade: ________ School: _________________
Name: _________________________ Grade: ________ School: _________________
Relationship to student: _______________________________
Choices for Volunteering (Please indicate area of interest)
Instruction
Library
Special Projects
___ General Classroom
___ Clerical/Shelving
___ Arts & Crafts
___ Computer
___ Storytelling
___ Bulletin Board
___ Language Arts Tutor
___ Calligraphy
Cafeteria
___ Mathematics
___ Lunchroom Facilitator
___ Display Case
___ Physical Education
___ Food Server
___ Drama
___ English Language Learners Tutor
Office
___ Music
___ Bi-lingual Tutor/Interpreter
___ General Duties
___ Child Care
____________________(language/s)
___ Telephoning
___ Field Trips
___ Talented and Gifted Program
Other
___ Fund Raising
___ Vocational Education
___ Volunteer Coordinator
___ Teacher
___ Special Needs Education
___ Health Screening
Appreciation
___ Publishing Center
___ Health Room Helper
___ Other ________________________
___ Playground
___ Other ________________________
___ I would be interested in being a presenter on these topics: ____________________________
______________________________________________________________________________
Emergency Information (list two people to contact in case of emergency):
Name: ____________________________ Relationship: _________________ Phone: ________________
Name: ____________________________ Relationship: _________________ Phone: ________________
Primary Doctor’s Name: __________________________________ Phone: ________________________
Do you have a hospital preference? ___ no
___ yes…Hospital _____________________________
Do you have a medical condition or are you taking medications we should know about in case of an
emergency? ___ no ___ yes…please explain _______________________________________________
_____________________________________________________________________________________
CCPS - Office of School Safety 08/05/08
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Parent category: Education