Volunteer Assurances Form/Quiz 2023-2024

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Please provide your First Name and Last Name as it appears on your government issued photo I.D. *

Please enter your best contact number. (This is used to contact you regarding the delivery of your volunteer badge.) *

Please enter your email address. *

Choose the school or schools that you are requesting to be a volunteer: *

Samuel Hubbard Elementary School

KB Sutton Elementary School

TG Scott Elementary School

Monroe County Middle School

Mary Persons High School

Monroe County Achievement Center

Required

A mandated reporter is any person required by law to report suspected child abuse or neglect *

TRUE

FALSE

If you make a report in good faith, you cannot be held liable.
*

TRUE

FALSE

You are working in the classroom with Monica and suspect physical abuse when you visit her at her foster parent's home. When should you report?
*

As soon as you suspect abuse or neglect (within 24 hours).

As soon as you get enough evidence to make sure the child is telling the truth.

Have you ever been convicted of a felony?
*

Yes

If you answered "Yes" to the previous question, please explain.

Please type your First Name and Last Name as you would like it to appear on your Volunteer Badge.
*

If you are a parent volunteer, please tell us the name(s) of your students(s) and the school(s) they attend.

Have you ever been investigated for allegations of sexual offenses?
*

Yes

Have you ever been accused of and/or investigated for a crime of child abuse or physical abuse?
*

Yes

Name of Emergency Contact
*

Phone number for Emergency Contact
*

Please provide your physical home address *

Please enter your Date of Birth as it appears on your government issued photo I.D.
*

YYYY

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