Summer on Bayshore HS Volunteer Interest
Please fill out to the best of your ability and accurately. If you have any problems or questions email Mrs. Chase at bchase@holynamestpa.org

A volunteer agreement must be filled out and returned before you begin your volunteer hours. The form can be found online, under the volunteer tab at: https://www.holynamestpa.org/elementary/summer-on-bayshore 

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Student First Name *
Student Last Name *
Street Address *
City, State and Zip code *
Student Home Phone
Student Cell Phone
Student Email address (school email preferred) *
Allergy/Medical Concerns *
Parent First and Last Name *
Parent Contact Phone Number *
Parent Contact Email address *
Additional Parent Contact Information (If needed)
Emergency Contact First and Last Name *
Emergency Contact Phone Number *
Grade (for 2019-2020 school year) *
Availability - Please indicate the dates and times you are willing to work below. We will try to accommodate your request. *
Morning (8:00am -12:30pm)
Afternoon (12:00pm-4:30pm)
Full Day (8:00am-4:30pm
Not available this week
June 3-7
June 10-14
June 17-21
June 24-28
July 8-12
July 15-19
July 22-26
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