2017-18 Volunteer Profile - English
To ensure the safety of all of our students, West Ottawa reserves the right to "approve" or "deny" any volunteer upon review of the background check returned through ICHAT (Internet Criminal History Access Tool). The determination will be based upon the individual's fitness to have responsibility for the safety and well-being of children. Providing false information is grounds for immediate volunteer denial. (Board of Education Policy 4120.09)
First Name *
Your answer
Middle Name
Your answer
Last Name *
Your answer
Maiden name or other name(s) previously used
Your answer
Date of Birth *
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Gender *
Required
Address *
(Street)
Your answer
*
(City)
Your answer
*
(State)
Your answer
*
(Zip)
Your answer
Phone number *
(Include area code)
Your answer
Email *
Your answer
Name of student(s)
Your answer
School of student(s)
Relationship to student(s)
Your answer
If you are not related to student(s), are you a community volunteer?
If you are a community volunteer, please list the organization you are working through, if applicable.
Your answer
Please indicate those areas in which you would like to volunteer. Check all that apply.
Agreement
I agree to abide by all relevant Board policies and administrative guidelines while on duty for the District. I understand that, although I am covered under the District's liability insurance policy, I am not covered by its health insurance policy nor am I eligible for workers' compensation. Should I become ill or suffer an accident while doing volunteer work for the District, I agree that I shall be responsible for any and all hospital and medical charges that may accrue.

I understand further that, as a volunteer, I am not in any manner considered an employee of the District or entitled to any benefits provided to employees. I further release the Board of Education from any and all liability for any damages, whatever their nature, which may result as a consequence of my volunteer services.

Electronic Signature *
Required
Please type your full LEGAL name *
Your answer
Today's Date *
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