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Delano Joint HSD  |  E  1240  Community Relations

Volunteer Assistance   

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REQUEST TO PERFORM VOLUNTEER WORK

Person or Group:______________________________________________

Telephone Number: ____________________________________________

Contact Person: ______________________________________________

Address: _____________________________________________________

Date(s) work to be performed: ________________________________

Area in which work is to be performed: _______________________

Brief description of work to be performed: ___________________

Estimated time to be spent: __________________________________

CSEA REVIEW

1. Has this work ever been performed by CSEA unit members?

______ Yes _______ No

Comments: ____________________________________________________

CSEA Recommendation: ______ Yes ______ No

Administrative Approval: ______ Yes ______ No

Signature _______________________________ Date____________

VOLUNTEER CERTIFICATION FORM

I, _______________________________ certify that I have never been convicted of a felony or misdemeanor other than a minor traffic ticket.

Signature ________________________________

_________________________ State of California

County of ___________________________

Subscribed and sworn (or affirmed) to before me this ________ day of ______________

_____________________________________

(Signature of Notary)

Exhibit DELANO JOINT UNION HIGH SCHOOL DISTRICT

Version: January 12, 1999 Delano, California