HORIZON HONORS 2017-2018 VOLUNTEER APPLICATION
This application MUST be completed every school year by all Horizon Honors volunteers prior to volunteering. You may begin volunteering on campus after completing this form.

Horizon Honors Volunteers are required to:
1. Have current volunteer application on file prior to volunteering in any capacity.
2. If chaperoning an overnight trip, a background check will be required.

VOLUNTEER INFO
Your current contact information.
First Name *
Do not use all capital letters.
Your answer
Last Name *
Do not use all capital letters.
Your answer
Home Address - Line #1 *
Do not use all capital letters.
Your answer
Home Address - Line #2
Do not use all capital letters.
Your answer
Home Address - City *
Do not use all capital letters.
Your answer
Home Address - Zip Code *
Your answer
Home Phone
ex: 555-555-5555
Your answer
Cell Phone
ex: 555-555-5555
Your answer
E-mail Address *
Do not use all capital letters.
Your answer
EMERGENCY CONTACT
List the person to contact in case of emergency.
Emergency Contact - Name *
Use "Firstname_Lastname". Do not use all capital letters. Ex: Jane Smith
Your answer
Emergency Contact - Home Phone
ex: 555-555-5555
Your answer
Emergency Contact - Cell Phone
ex: 555-555-5555
Your answer
Emergency Contact - Relationship *
The Emergency Contact's relationship to you. Ex: Mother, Co-Worker, Friend.
Your answer
CHILDREN @ Horizon Honors
Please list only your children that are currently enrolled at a Horizon Honors school.
Child at Horizon Honors #1 - Name and Grade *
List your child's name and grade. Do not use all capital letters. Ex: Jane Smith - 3
Your answer
Child at Horizon Honors #2 - Name and Grade
List your child's name and grade. Do not use all capital letters. Ex: Jane Smith - 3
Your answer
Child at Horizon Honors #3 - Name and Grade
List your child's name and grade. Do not use all capital letters. Ex: Jane Smith - 3
Your answer
Child at Horizon Honors #4 - Name and Grade
List your child's name and grade. Do not use all capital letters. Ex: Jane Smith - 3
Your answer
CRIMINAL HISTORY/BACKGROUND
Horizon Honors' responsibility in protecting the interest of our students/staff/parents/community is taken seriously; therefore, the following information is required of all applicants. A record of conviction does not prohibit volunteering: however, failure to complete this form truthfully, accurately, and completely may mean disqualification from consideration of volunteering or possible dismissal from a volunteered position, as well as possible prosecution for filing false information with a public agency. If you answer “yes” to any question below, HCLC may contact you and require further written explanation.
Have you ever been dismissed from a position? *
Required
Have you ever used any other name for personal reasons or employment? *
Required
If "yes," please list the name(s) here.
Include first name and last name. Do not use all capital letters. Ex: Jane Smith
Your answer
Have you ever had any license or certificate of any kind revoked or suspended, sanctioned or any charge or complaint now pending against you before any licensing, certification or other regulatory agency, public or private? *
Required
Have you ever been convicted of, admitted committing, or are you awaiting trial for any crime (excluding only minor traffic violations not involving any allegation of drug or alcohol impairment)? Please note: If you answer yes, please send your child's principal an email with an explanation of the violation. *
Conviction means the final judgment or a verdict or a finding of guilty, a plea of nolo contendre, in any municipal, state or federal court of jurisdiction in a criminal case, regardless of whether an appeal is pending or could be taken. Conviction does not include a final judgment, which has been expunged by pardon, reversed, set aside, or otherwise set aside, or rendered invalid. You must answer “yes” even if the event was later dismissed, deferred, vacated or expunged.
Required
Have you ever been convicted of a dangerous crime as defined in A.R.S. 13.604.01? Please note: If you answer yes, please send your child's principal an email with an explanation of the violation. Please note: If you answer yes, please send your child's principal an email with an explanation of the conviction. *
A.R.S. 13.604.01 requires applicants to give notice of any conviction of dangerous crimes against children. These crimes are defined as second degree murder, aggravated assault, sexual assault, molestation of a child, sexual conduct with a minor, commercial sexual exploitation of a minor, sexual exploitation of a minor, child abuse, kidnapping and sexual abuse if any of these crimes are conducted against a minor under age 15.
Required
SIGNATURE
I authorize the following: investigation of all statements, including herein and understand that any document relevant to this information may hereby be reviewed by Horizon Honors. Information, which becomes part of this record, will be regarded as confidential and will not be available to me now or at any future time. I authorize Horizon Honors to make reference checks prior to appointment and I will execute documentation to facilitate this investigation. I understand that misrepresentation or omission of pertinent facts may preclude me from volunteering. All other volunteer paperwork must be submitted in accordance with the school’s timelines. By providing my full name below, I am agreeing to the above statement.
Type Your Full Name Here *
Ex: Jane Marie Smith
Your answer
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