The 18th Annual

TAKE OUR DAUGHTERS AND
SONS TO WORK DAY

◊◊◊

THURSDAY, APRIL 28, 2011

8:15 A.M. -- Vola Lawson Lobby, at City Hall

MENTOR APPLICATION
Due Friday, April 15

Date of Application (required): type the date as shown here :

Name:

Occupation:

Work Address:

Work Phone:

Fax No.:

Email Address:

This is my first time volunteering with Take Our Daughters and Sons to Work Day: Yes No

IN CASE OF EMERGENCY ON DAY OF EVENT, PLEASE PROVIDE YOUR CELL PHONE NUMBER AND ALTERNATE CONTACT AT YOUR PLACE OF WORK:

Please check one:

	Pair me with a student for the day I would prefer to be paired with (select one): daughter son either (or both for volunteering to take more than 1 student). Number of students you or your office would like to mentor:
	I will be bringing a child to work. Name of child: (City of Alexandria employees only)
I am willing to attend an evening mentor orientation session prior to the 16th Annual Take Our Daughters and Sons to Work Day Event.
	Yes No Maybe
How did you hear about the 18th Annual Take Our Daughters and Sons to Work Day Event?
	Salute To Women Banquet Internet Word of Mouth Past Volunteer Other (please describe)
Special notes/requirements for student (i.e. age requirement, needs to have photo ID, must wear comfortable shoes):

You are invited to attend the opening reception at 8:15am at Alexandria City Hall, 301 King Street, in the Vola Lawson Lobby. You will be paired with your “daughter” or “son” during the ceremony. Please let us know if you need to depart the ceremony early to get to work, so we can make sure your matching is done as soon as possible after the students arrive.

We will confirm your student’s name(s) on or prior to April 27th and provide a suggested schedule for the day. Your participation will be based upon the availability of students and their career interests. On occasion, students are absent on the day of the event; however, we will not know prior to the reception.

As a mentor, your responsibilities will include providing lunch for your student and returning them to school in the afternoon. Parents will have completed a permission form indicating their consent for you to transport their child. Check with your student about his/her bus schedule. Students must be returned no later than 3:45pm to take an activity bus home.

Thank you for your participation in this important program.

The 18th Annual

TAKE OUR DAUGHTERS AND SONS TO WORK DAY

THURSDAY, APRIL 28, 2011

TAKE OUR DAUGHTERS AND
SONS TO WORK DAY