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Home › Preschool Reading Buddies › 2019-20 ACPC Reading Buddies Volunteer Application

2019-20 ACPC Reading Buddies Volunteer Application

Thank you for your interest in volunteering for ACPC Reading Buddies. The program takes place October through April each Monday and Tuesday morning from 9:00am-10:00am. Please fill out the following application form to assist with this beneficial program!

Contact Lisa at director@raising-readers.org or 515-520-8686 for additional information or with any questions you may have.

* Indicates a required field

First Name:

*

Last Name:

*

Home Address:

*

Please list your FULL address

Email Address:

*

Phone Number:

*

xxx-xxx-xxxx

Are you an ISU student, faculty, or staff?:

*

Yes

No

Are you under 18 years old?:

*

Yes

No

Reasons for volunteering for ACPC Reading Buddies program:

Background:

Are you a current or retired elementary school teacher?:

No

Current Teacher

Retired Teacher

Community Service Experience:

What new skills or experiences would you like to gain as a volunteer?:

In case of emergency, please list two (2) emergency contacts:

*

Name, Phone Number, and Email

Where/How did you find out about our ACPC Reading Buddies program?:

*

Email from Raising Readers in Story County/Past Volunteer

RRSC e-newsletter

Word of Mouth

A flyer

Social Media

Volunteer Center of Story County posting

Your School District

ISU class

Other

If other or ISU class, please specify:

Avaliability Section

ACPC Reading Buddies

ACPC Reading Buddies:

920 Carroll Ave, Ames

9:00 a.m. - 10:00 a.m. on Mondays

9:00 a.m. - 10:00 a.m. on Tuesdays

9:00 a.m. - 10:00 a.m. on Mondays and Tuesdays

Would you be willing to serve as a substitute volunteer?:

Yes. I wish to be a substitute volunteer only.

Yes. I am available to sub at another time in addition to volunteering at the time indicated above.

No. I am not interested in subbing at this time.

I am an Iowa State student and can only volunteer for one semester:

I will volunteer both semesters

I can volunteer Fall semester only

I can volunteer Spring semester only

I am not an ISU student

Please list any dates between October 7, 2019 and April 2020 you will be unable to volunteer. :

*

Authorized Surveillance Method:

*

Photo Consent Form

I hereby consent that photographs, video, and/or interview information of me by RRSC staff or agents or by members of the news media may be used by them for the purpose of illustration, teaching, publicity or publication in any form.:

*

Yes

No

Background Check

I give permission for RRSC to perform a background check before my volunteer application is accepted and agree that all information submitted is accurate.:

You cannot volunteer with this program without a cleared background check.

*

Yes

No

Birthdate:

*

(mo/da/year)

Home Address since 2016:

*

We need three years of home addresses for background check. Write 'same' if address has not changed.

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Please make sure you hit 'Submit' to finalize your application. Thank you!

2019-20 ACPC Reading Buddies Volunteer Application

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Contact

Raising Readers in Story County
P.O. Box 2374
2801 Grand Ave #1030
Ames, IA 50010

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