JACK ELEMENTARY

Patriot D.A.D.S. (Dads and Dedicated Students)

Registration Form

Name: ____________________________ Email: _____________________

Address: ________________________________ City: ______________________

Zip:_____________

Phone(s) Home: _________________Cell: _________________Work: __________________

Place of Employment: _______________________________________________________________
Student’s Name Grade Teacher Relationship
　 　 　 　
　 　 　 　
　 　 　 　
　 　 　 　
　 　 　 　

List any area(s) of expertise that you would like to share with students: ______________________________________________________

Tyler ISD requires all volunteers to submit to a criminal background check. All information is confidential. Approved volunteers will be issued a Volunteer Badge for the current school year. The badge must be displayed at all times while serving in this capacity. Please submit your volunteer application on-line at:

http://www.tylerisd.org/04PARENTS/volunteers.htm

Date(s) available to volunteer: ______________________________________

___________________________________ ______________________________

Signature Date

All Dads, please return this form in one of the following ways:

Fax to Jack Elementary: 903-262-3329

Mail to Jack Elementary: 1900 Balsam Gap, Tyler, TX 75703

Drop the form off at the office or with your child’s teacher

Thank you for supporting our school and children through this program! If you have questions, please contact Jack Elementary at 903-262-3260 or Steve Cooper at 903-509-1291.