2018-2019 MSD of Decatur Township Volunteer Form
Please read the information below before completing the volunteer form.
In an effort to keeping our schools safe, all volunteers (including staff) must complete a volunteer application form/criminal background check request and be approved as a volunteer prior to volunteering. This form must be completed at least (5) business days prior to the event in which the volunteer chooses to participate. Volunteer background checks are completed by the Parent Liaison using the State of Indiana Police criminal records database and the US Department of Justice National Sex Offender website database. At the beginning of the school year, It may take up two weeks to process volunteer forms.
When evaluating volunteer criminal background checks, if the following charges appear on a volunteer background check, the volunteer will not be permitted to volunteer in our schools. Volunteer criminal background checks are evaluated on charges filed, not the disposition of the charges.
Charges:
Felony Charges or felony convictions
Drug charge (felony or misdemeanor) with in the last 10 years
Battery charge with in the last 10 years
Child abuse or neglect
Theft charge with in the last 7 years
2 or more DUIs or alcohol-related charges with in the last 5 years
Any charges currently pending
Any misrepresentation on the volunteer application
Any other charge not mentioned above, but determined to be a risk to students
If a volunteer is not permitted to volunteer in our schools due to pending charges, at the time the pending charges are resolved, the volunteer’s status will be re-evaluated.
Background Check Required:
Assisting with supervising class parties

Assisting school staff in the classroom or school building

Attending Field Trips

Background Checks Not required:
Attending Meet the Teacher Night

Family Events

Attending extra-curricular or other school-sponsored events as a spectator

Attending the school book fair

*Volunteer criminal backgrounds checks are valid for 1 year. *Each year volunteers will be required to complete a new volunteer request form, and the status as a volunteer will be reconsidered.
Name (First & Middle): *
Your answer
Last Name: *
Your answer
Date of Birth: *
Your answer
Race (Choose one of the following): *
Gender *
Address: *
Your answer
Phone Number: *
Your answer
Email Address (current): *
Your answer
Student Information:
Name of Student(s):
Your answer
Grade(s):
Your answer
Teacher(s):
Your answer
Name of Schools (If you have more one child attending click on schools they will be attending):
Liberty
Blue Academy
Gold Academy
Stephen Decatur
Valley Mills
West Newton
Decatur Middle School
Decatur Township School for Excellence
Decatur Central High School
Areas to volunteer:
Check this box if interested
Help in classroom
Field Trips
Book Fair
Field Day
Decatur High School Band (Middle & High School Students)
Classroom Parties
Popcorn Fridays-Elementary
PTO
Student observation-College Student
Reading to students (classroom)
Winter/Spring Carnival
Rolls Royce
Community Member/College Student: Where would you like to volunteer?
Are you a MSD of Decatur Employee?
What school?
Are you a relative to a MSD of Decatur Staff member? Please answer the following:
Staff Member's Name / Relation:
Your answer
What school?
If there is an issue that you believe may be presented on the back ground check that you would like to explain, please do so now. Have you ever been arrested for or convicted of a crime that has not been expunged by a court? This information will be considered confidential and will only be viewed by those involved in the approval process.
Issue:
Your answer
Please note that the information received will be used to determine your eligibility as a suitable volunteer for the MSD of Decatur Township Schools. All information received is considered “confidential” , and will only be viewed by a select group of employees who have been assigned the task of determining eligibility. You may request at any time a copy of what was used to determine your eligibility, as well as information detailing policies and procedures pertaining to what is considered “confidential” and how your information is protected. Also note that the process of determining a volunteers’ eligibility with the MSD of Decatur Township Schools will be conducted yearly, included in this process will be written permission from the volunteer to conduct security checks. **Initial and Date (This will serve as your electronic signature that all information is correct).
Your answer
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