Organization Name

Contact Person

Mailing Address, City, State, Zip

Phone Number

Email Address

Mission/Activities of the Organization

Services/Curriculum to Offer the Helena School District

Target Age Group (choose as many as appropriate)
Primary (pre-K- grade 3)
Intermediate (grades 4-5)
Middle (grades 6-8)
High School (grades 9-12)

Availability

Level of Screening and Training Organization's Employees/Volunteers Receive

Schools/Programs the Organization has Previously Worked With

We authorize the Helena School District to use images/photographs of our volunteers for the purpose of volunteer recruitment and volunteer recognition.
Yes
No

We understand that our organization will be working as volunteers with pre-Kindergarten through 12th grade students and know of no reason why we should not work in this capacity. We affirm that the information we have provided is accurate.
Yes
No