300a Volunteer Information Form Page 2
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1
2If required, do you authorize the NLESD to contact the person/ organization listed below and for the person/organization to
disclose information for the purposes of obtaining a personal reference regarding your suitability for volunteer activities?
Yes
No
Name of Reference
Relationship
Position/Activity
Phone No.
Complete the following information if requested by school administrator or designate:
Spoken:
Engli
Frenc
Other ________
Languages:
French
Written:
glish
Frenc
Other ________
Skills:
rts
glish
Languages
Science
eography
Library
eyboarding
Business
andicrafts
Writing
ters
ealth
ic
ance
ry
ffice
rama
er
_______________
___________-
Program/Activity Area: (please indicate your area(s) of interest)
oom
ring
SL
ters
Literacy
/Fairs
richment
Library
Special Ed.
Sports/Coach
Fundraising
rips/Event
Languages
er __________
Grade Level Preferred:
ergarten
-6
Secondary
-3
-9
Personal History
Education and /or work experience:
Certificates/Training:
Volunteer experience:
If I take on a role of volunteer with the NLESD, I will hold in confidence all information and material received
from and about students and/or personnel that may come to my attention in the course of my duties. Furthermore,
I agree to return all personal/confidential information to the school for appropriate storage or disposal.
Volunteer’s Signature: _______________________________________________ Date: ______________________________
Interviewed by: _____________________________________________________ Date: ______________________________
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