Black Butte School Volunteer Application

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Black Butte School is proud of its history of volunteers helping to make the school a vibrant educational experience that is connected to our community. We welcome and seek out volunteers from our community. Volunteering in a school is a unique and exciting experience. It is a privilege for both the school and the volunteer. Volunteering promotes and maintains a supportive relationship with the students and staff. We can't thank our volunteers enough for being willing to be a supportive part of the Back Butte School education program!

In addition to filling out this form, to become a volunteer at Black Butte School you will also need to read and complete the volunteer packet, consent to a background check, submit proof of COVID-19 vaccination or medical/religious exemption, and complete an online training.

Please refer to www.blackbutte.k12.or.us/volunteer for more information.

Email *

Today's Date *

YYYY

Last name *

First name and Middle Initial *

Preferred Pronouns *

he/his/him

she/her/hers

they/them

other

Address line one *

City, State, Zip *

Phone *

Birth Date (required for background check) *

YYYY

Sex (required for background check) *

Describe any relationship you have to current BBS student(s) or staff member (if any). *

Days and times you would like to volunteer *

Skills and Interests *

Previous Volunteer Experience

Check the box(es) of the volunteer activit(ies) you are interested in:

Facilities/Landscaping Projects

Site Council

School Board

Budget Committee

Library/Media

Clerical/Office

Parent Teacher Organization (PTO)

Field-Trip Chaperone

Classroom Assistant - Math

Classroom Assistant - Literacy / Humanities

Classroom Assistant - P.E.

Classroom Assistant - Arts (music, visual, performing)

Classroom Assistant - science/field studies

Academic Tutoring

Student Mentoring

For office use only: Background check completed

Yes

Clear selection

For office use only: Online training completed

Yes

Clear selection

For office use only: proof of COVID-19 vaccination or medical/religious exemption received

Yes

Clear selection

For office use only: Signed Volunteer Acknowledgement Release of Liability

Yes

Clear selection

For office use only: Signed Criminal History Verification

Yes

Clear selection

A copy of your responses will be emailed to the address you provided.

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