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Attachment A Los Angeles Unified School District School ...

Attachment A Office of the Chief Academic Officer Page 6 of 12 September 16, 2009 Los Angeles Unified School District School Volunteer Application PARENT ____ STUDENT*____ COMMUNITY____ ** ____ STAFF: _____ ORG. /PARTNERSHIP: _____ (At Child s School ) (LAUSD K-12) (other Adult) (Age 55 +) (LAUSD Employee s) (Other than LAUSD) Dear potential volunteer, TO BE COMPLETED BY LAUSD School PERSONNEL OR PARTNERSHIP/ORGANIZATION: Date application received by coordinator: Month _____ Day _____ Year_____ New Volunteer: _____ Continuing Volunteer Previous School Name _____ Year:_____ If volunteer is a LAUSD employee please submit (his/her) employee number: _____ MAILING LIST (date) Organization / Partnerships: _____Number of Hrs.

Attachment A BUL-4841.0 Office of the Chief Academic Officer Page 6 of 12 September 16, 2009

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