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2013 reader volunteer form

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2013 reader volunteer form

  1. 1. 2013 Chelmsford Community Read-In April 8th – April 12th I would like to participate in the 2013 Community Read-In! Name ___________________________________________ Business ________________________________________ Address _________________________________________Email address________________________________________________________________Phone _______________________________ Preferred form of contact: phone / emailMy preference is for grade (please circle grade preference) :CHIPS Pre-K (Westlands Only) K 1 2 3 4 5 6No preference _________Particular class requested (if any): _______________________________My preference is to read at the following school(s):Byam ___ Center ___ Harrington ___ South Row ___ Westlands(Chips) ___McCarthy___Parker___ No preference __________The best day for me is:April 8 ____ April 9____ April 10 ____ April 11 ____ April 12 ____The best time of day for me is:Morning ____ Afternoon ____ Any specific time frame better? ___________________Number of classes I would like to read to: _______Are you a High School Student: Yes* / No If yes, do you have transportation: Yes / No* If yes, what specific time is preferred (please do not indicate by block only) _________ Please email chelsmfordreadin@gmail.com or return form to: Tara Trainor, 25 Middlesex St, North Chelmsford, MA 01863 By March 9, 2012. Thank you!!----------------------------------------------------------------------------------------------------------------For Coordinator’s Use Only:School _____________ Grade ____ Teacher ________________ Room ____ Date __________Time_____School _____________ Grade ____ Teacher ________________ Room ____ Date __________Time ____School _____________ Grade ____ Teacher ________________ Room ____ Date _________Time______

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