Volunteer Registration
2013/2014

* - Required Fields
Volunteer Information
* First Name:
* Last Name: * Date of Birth:
* Address: Gender:
* City: Primary Phone: (xxx) xxx-xxxx
* State: Alternate Phone: (xxx) xxx-xxxx
* Zip: Email address:
* Driver's License/State ID: , * Issuing State:

Building Information
* In which Building/School would you like to volunteer:
* Do you have a child in this building?
What specific skills or training do you have?

Emergency Contact Information:
NameRelationshipAddressPhone
*1)
2)
3)


Volunteer Agreement
I hereby give my permission for Dayton Public Schools to use my name, likeness and speech in any audiotape, videotape, film or photograph made during my volunteer service, for any business purpose during the school year, as indicated by submitting this registration.

I certify that the information herein and any accompany documents are true. I understand that falsification of any information herein may result in the denial or termination of my volunteer service.

By submitting this form, I authorize Dayton Public Schools to verify, obtain copies of records, and gather information pertaining to this volunteer registration.

I have read the Dayton Public Schools Volunteer Guidelines and agree to return my name badge when my volunteer service is complete.

By submitting this form, I certify that the information provided on this Volunteer Form is true to the best of my knowledge. I understand that the information I provided is subject to verification and that I may be asked to provide additional supportive documentation. Furthermore, I understand that my volunteer services may begin upon the approval of this form. As a volunteer I agree to comply with all of Dayton Public Schools established rules, policies, and procedures. I understand that this volunteer form is effective for the current school year only and my volunteer service may be terminated at any time.


We appreciate the time you have taken to complete this form. The information you provided will help us ensure that you have a valuable and satisfying volunteer experience.