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Contract for Services Provider Application
If you are at this page it is because you have been offered an opportunity to provide a service to the BISD through a Contract for Services Agreement.  

Before a contract can be signed by the BISD and payment initiated to you as a contract service provider, we request that you complete the following application. The Contract Service Provider process provides BISD with required and helpful information about you and it ensures your safety as well as the safety of our students and staff.  All contract service providers who work directly with children must complete the application and screening procedure BEFORE working in our schools in any capacity and before they can be paid.

There are three parts to the application procedure:

1.Read the BISD Contract Service Provider Orientation Training & Handbook 
https://docs.google.com/document/d/1r9MeMV4nmVNx12WX5m_64kVq0YNSSTZTsOcbVEukkhM/edit?usp=sharing

2. Complete the hard copy of the Contract for Services Agreement that has been sent to you along with both the Department of Retirement System and W-9 form.  You will return these things along with a copy of your picture ID as directed by the administrator who has communicated with you about this work.

3. Complete the application below


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LAST name as it appears on your driver license: *
FIRST name as it appears on your driver license: *
Middle initial (if you don't have one, write 'none') *
Other names *
Business Name if applicable *
Email *
Phone number *
Short description of contract duties: *
When did you read the Training & Handbook? *
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When did you read the Lockdown/Active Shooter Training? *
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In order to ensure that contract service providers clearly understand the related policies and procedures of the Bainbridge Island School District (BISD), anyone wishing to work or volunteer in the schools must participate in the below application. Place your initials by each of the following items to signify consent and understanding.
Place your initials as they match the name on your driver license in the text box following each item. This indicates that you will abide by the statements.
STATEMENT#1 DISTRICT RIGHTS:  I understand that working as a contract service provider is a privilege, not a right, and that the District may, in its sole discretion, decide to discontinue any contract service provider's / volunteer's participation at any time and for any reason or no reason with or without notice or warning.

I agree with statement #1: *
STATEMENT #2 - CONTRACT SERVICE PROVIDER / STUDENT BOUNDARIES: I understand that contract employees will not intrude on a student's physical or emotional boundaries. A boundary invasion is an act or omission that violates professional boundaries and has the potential to abuse the staff or contractor/student relationship. *
Policy & Procedure 5253: Maintaining Professional Staff/Student Boundaries Note: Contractor is always synonymous with Staff.
I agree with statement #2: *
STATEMENT #3 - DISCRIMINATION, HARASSMENT, INTIMIDATION AND BULLYING: The District is committed to a safe and civil educational environment for all students, employees, parents/legal guardians, volunteers and patrons that is free from harassment, intimidation, bullying and cyber-bullying. Harassment, intimidation and bullying are defined as any intentional verbal or physical act or any written message or image, including those that are electronically transmitted, that have the purpose or effect of materially or substantially interfering with an individual's educational or work performance, or creating an intimidating, hostile, or offensive educational or work environment. Prohibition Against Sexual Harassment is defined as unwelcome sexual advances, or requests for sexual favors, or sexually-motivated physical contact, or other verbal or physical conduct or communication of a sexual nature. If I observe, overhear, or otherwise witness harassment, intimidation or bullying of any kind, I am required to take prompt and appropriate action to stop the harassment and report it to the school administrator. *
Policies & Procedures 3700 and 5013: Prohibition Against Sexual Harassment; and 3706 and 5015: Prohibition Against Harassment, Intimidation and Bullying. Place your initials as they match the name on your driver license in the text box. This indicates that you will abide by the statements.
I agree with statement #3: *
STATEMENT #4 - I will respect the confidentiality of students and staff members.
Place your initials as they match the name on your driver license in the text box. This indicates that you will abide by the statements.

I agree with statement #4: *
STATEMENT #5 - I will respect culture, religion and lifestyle diversity, and conform to federal and state laws prohibiting discrimination on the basis of race, color, national origin (including language), sex, sexual orientation (including gender expression or identity), creed, religion, age, veteran or military status, disability, or the use of a trained dog guide/service animal.
Volunteer Handbook, page 1, and Policy & Procedure 3211: Equal Educational Opportunity: Prohibition Against Discrimination. Place your initials as they match the name on your driver license in the text box. This indicates that you will abide by the statements.
I agree with statement #5: *
STATEMENT #6 - I understand that my conduct in and around district facilities includes: no smoking or tobacco, no weapons, no drugs or alcohol, and no use of school equipment for personal purposes. *
Volunteer Handbook, page 8. Place your initials as they match the name on your driver license in the text box. This indicates that you will abide by the statements.

I agree with statement #6: *
List any crimes you have been convicted of, found guilty of, pled guilty to, or did not contest. Provide sufficient details to enable BISD to evaluate the gravity of the crime, including the charge, date, court, case number, and penalty. Enter "None" if applicable. *
Do you currently have any outstanding criminal charges or warrants for your arrest pending against you? *
If you answered "yes," please provide pertinent details to enable BISD to evaluate, including the charge, date, jurisdiction, and status. Enter "None" if applicable. *
Are you presently under investigation for possible criminal charges? *
If you answered "yes," please provide all pertinent details, including the jurisdiction that is doing the investigation and the nature of the investigation to the extent it is known. Enter "None" if applicable. *
Have you ever been found in any dependency or domestic matter to have physically abused any child or person? *
If you answered "yes," please provide the pertinent details to enable BISD to evaluate, including the court, case number, date, circumstances, and finding. Enter "None" if applicable. *
Pursuant to RCW9A.72.085, I certify under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Please place your complete name as it appears on your driver license. *
Enter today's date *
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