CCS Volunteer Application
Thank you for your interest in volunteering at Crossroads Charter Schools. Applicants age 18 and over must complete a background screening through the Family Care Safety Registry Background Screening System prior to volunteering at Crossroads. Yearly background screenings will be completed for volunteers. If you have questions feel free to contact Community Engagement Coordinator, Nina Ward at nward@crossroadsschoolskc.org or 816-221-3191 ext. 331.
Email Address *
Your answer
Name (First, MI, Last) *
Your answer
Date of Birth (mm/dd/yyyy) *
Your answer
Address (Street, City, State, Zip Code) *
Your answer
Home Phone *
Your answer
Cell Phone
Your answer
Are you a parent/guardian/family member of a current Crossroads Charter School Student? *
If yes, please list student(s) name, campus and grade. *
If you are a community volunteer please mark NA
Your answer
MO residents, are you registered on the MO Family Care Safety Registry? *
Please note that we cannot approve your application until we receive a copy of your background screening. Contact Missouri Family Care Safety Registry at (866) 422-6872 to request a background screening. FCSR will complete the screening, then send you a copy of the screening via email &/or mail. Once received, please send a copy of the screening letter to Crossroads Charter School Community Engagement Coordinator, Nina Ward via email nward@crossroadsschoolskc.org or in person.
Applicant Signature *
By providing my electronic signature I agree to the following statement: I understand that to be considered for acceptance as a Volunteer at Crossroads Charter Schools (CCS), I must complete all components of the volunteer application process, including a Volunteer Application and background check. I authorize CCS to investigate all statements in my Volunteer Application and to verify any necessary information from my references and appropriate governmental agencies, including, but not limited to, driver’s license, criminal background and child abuse/neglect records and sex offender registry, and I hereby consent to such verification and disclosure of information to CCS. All information obtained by CCS during the volunteer application process will be kept confidential. I declare that all of the statements contained in my VolunteerApplication are true, correct and complete to the best of my knowledge. I understand that any omissions or misstatements made by me on the Volunteer Application or during the application process may be cause for my application to be denied or volunteer placement to be terminated. I hereby release CCS from any and all liability arising from its giving or receiving information about my suitability as a CCS volunteer.Waiver and Release. I, hereby, release and forever discharge and hold harmless CCS, and each of its directors, officers, employees,agents, successors and assigns, from any and all liability, claims and demands of whatever kind or nature, either in law or equity,which arise or may hereafter arise from the volunteer services I provide CCS. I understand that CCS does not assume any responsibility for or obligation to provide me with financial or other benefits or assistance, including medical, health or disability insurance coverage, in the event of my injury, illness, death or damage to my property arising out of my services to CCS. I understand that I am responsible for securing my own insurance coverage prior to volunteering with CCS.
Your answer
Date of Application *
MM
/
DD
/
YYYY
Next
Never submit passwords through Google Forms.
This form was created inside of Crossroads Charter Schools. Report Abuse - Terms of Service