First Name:
*
Last Name:
*
Authorized Submission Number: *
Home Address:
*
Please list your FULL address
Email Address:
*
Phone Number:
*
xxx-xxx-xxxx
Are you an ISU student, faculty, or staff?:
*
Are you under 18 years old?:
*
Reasons for volunteering for Story Pals program:
Background:
Are you a current or retired elementary school teacher?:
Community Service Experience:
What, if any, new skills would you like to learn as a tutor?:
In case of emergency, please list two (2) emergency contacts:
*
Name, Phone Number, and Email
Where/How did you find out about our Story Pals program?:
*
If other, please specify:
SITE REGISTRATION
I am only interested in serving as a substitute volunteer:
I am an Iowa State student and can only volunteer for one semester:
Nevada
Central Elementary School:
910 10th St, Nevada
Ames
Northwood Preschool:
3012 Duff Ave, Ames
Colo-NESCO
Colo-NESCO Elementary :
407 North St, Zearing
Please list any dates between October 2019 and April 2020 you will be unable to volunteer. We follow the Iowa State academic schedule and do not have sessions during university breaks:
*
Tutoring Agreement 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.:
*
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.
*
Birthdate:
*
(mo/da/year)
Home Address since 2015:
*
We need three years of home addresses for background check. Write 'same' if address has not changed.
grip-e-hp
