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BCSD Volunteer Registration Form
The Volunteer Registration Form must be completed and approved by the Board of Education PRIOR to participating in any volunteer role in the BCSD. Please fill out one form per adult/volunteer.
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* Indicates required question
First Name
*
Your answer
Middle Name
*
Your answer
Last Name
*
Your answer
Additional Names Used
Your answer
Date of Birth:
*
MM
/
DD
/
YYYY
Address:
*
Your answer
Phone:
*
Your answer
Email:
*
Your answer
Method of Contact Preferred:
*
Phone
Email
Both Phone and Email are acceptable
Other:
Are you a parent/legal guardian of a child/children in the district?
*
Yes
No*
*If NO, indicate relationship to district:
Grandparent
Other family member
Friend
Other:
Clear selection
Student 1
Please list student information separately for multiple students.
Student 1: Student's name:
*
*If not volunteering for a specific student put n/a
Your answer
Student 1: Building student attends:
*
If not volunteering for a specific student select N/A
Choose
Page
Lincoln
Franlkin
Boone Middle School
Boone High School
Futures
N/A
Student 1: Student's grade level:
If not volunteering for a specific student put n/a
Choose
Preschool
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Student 1: Student's teacher:
Your answer
Additional students if applicable
Student 2: Student's name:
*If not volunteering for a specific student put n/a
Your answer
Student 2: Building student attends:
If not volunteering for a specific student select N/A
Choose
Page
Lincoln
Franlkin
Boone Middle School
Boone High School
Futures
N/A
Student 2: Student's grade level:
If not volunteering for a specific student put n/a
Choose
Preschool
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Student 2: Student's teacher:
Your answer
List additional student's information:
Student's Name, Student's Building, Student's Grade, Student's Teacher
Your answer
I have read the Volunteer Handbook. (Handbook can be found at
https://core-docs.s3.amazonaws.com/documents/asset/uploaded_file/1067586/Volunteer_Handbook__1_.pdf
) I understand my responsibilities and agree to perform my duties according to these guidelines.
*
Yes
No
I agree to maintain the confidentiality of all information that I generate or to which I have access as a volunteer.
*
Yes
No
Have you ever been convicted of a felony or misdemeanor (excluding traffic violations)?
*
Yes*
No
Have you ever been convicted, accused, or had an administrative finding, of violating any law involving child abuse, sexual abuse, physical abuse, sexual harassment or exploitation, or any other crime related to children?
*
Yes*
No
Do you currently have charges pending or accusations that may lead to legal action relating to the aforementioned?
*
Yes*
No
A “YES” answer to any question requires an additional form to be filled out for a DCI background check to be conducted.
In consideration for the safety and well-being of our students, the Boone Community School District will do an Iowa Courts Online and Sex Offender Registry check prior to approving any/all volunteer applications. The BCSD reserves the right to conduct an Iowa criminal history record check with the Division of Criminal Investigation (DCI), Child Abuse Registry, and Adult Abuse Registry for all volunteers working within the school district. Prior to completing a DCI check, the volunteer will be notified by the Central Office, and a Non-Law Enforcement Record Check Request Form will be completed and signed by the volunteer.
*
By checking this box you have agreed to the terms and conditions of this form and all the answers are true and correct to the best of your knowledge.
Required
*
By checking this box this will be considered acknowledgment as your digital signature for this form.
Required
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