Tiger Connection Survey for business leaders

1.	Business/Organization Name*

2.	What type of business/industry do you represent?

3.	Contact Person's Name*

4.	Contact Person's Email Address*

5.	Contact Person's Phone Number*

6.	Our business/organization would be willing to have a representative come to a school and speak about
	Leadership    Workplace etiquette/expectations    Cultural Heritage    Hobbies/Interests    Participate in mock interviews with students    If you checked "Cultural Heritage," "Hobbies/Interests" or have another subject you would like to speak about, please explain below:

7.	If you checked that you are willing to speak, please check all age groups that a representative from your business would be willing to speak to:
	Pre-K (3 and 4-year-olds)    Kindergarten - 5th grades    6th, 7th and 8th grades    9th -12th grades    Adult students at the Waynesville Career Center

8.	We would like to have a representative of our business come to a school and read to students. We would prefer to read to:
	Pre-K (3 and 4-year-olds)    Kindergarten - 5th grades    6th, 7th and 8th grades    9th - 12th grades

9.	We would like to have students come and sing and/or share a theatrical performance at our business. The number of students our office could accommodate is

10.	We would like to display artwork at our office/building. We have the following available:
	window space to display artwork    counter space for sitting works of art    wall space where we would be willing to display or hang artwork for up to 30 days

11.	We would be willing to conduct a fund-raiser at our business, such as a jeans day for our employees, for Snack in a Pack, which provides food for students who might otherwise go hungry over weekends and holidays.
	--None--Yes No

12.	We would be willing to hang posters in our business about upcoming school and school-related events.
	--None--Yes No

13.	A representative from our business would be willing to participate in a focus group about a school-related issue.
	--None--Yes No

14.	A representative from our business would be willing to mentor a student. This would require meeting with the student at least twice a month for at least 20 minutes.
	--None--Yes No

15.	A representative from our business would be willing to volunteer at a PTO carnival to assist with games, prizes, tickets, etc.
	--None--Yes No

16.	Please list any other ways your business would like to volunteer to work with the Waynesville R-VI School District or use this space to provide more details about any of your answers above.

	To submit this survey to the district, please click on DONE. (If you click save, we will not see it.) Please note that to participate in some of these activities, a satisfactory background check may need to be completed. If you have any questions, please feel free to email Marianne Ward at PR@waynesville.k12.mo.us.