Volunteer Clearance Form
Parent First Name *
Your answer
Parent Last Name *
Your answer
Address (Street, City, Zip)
Your answer
Date of Birth (Parent Volunteer) *
Your answer
Gender *
Required
California Driver's License or California I.D. Number *
Your answer
Phone Number (Include Area Code) *
Your answer
School(s) Where You Will Volunteer *
Required
Signature *
By typing my name I authorize the Pleasanton Unified School District to submit this information to the Pleasanton Police Department to complete the volunteer screening process.
Your answer
Confidentiality Statement
I understand that in the course of my volunteer association with Pleasanton Unified School District, I share the responsibility of maintaining student, employee and District confidentiality as to any information, whether written, verbal or by actions observed, which I may have available to me. I further understand that in the course and scope of my volunteer status, I am not to discuss academic, social or other confidential information regarding students or school employees with anyone, including the parents of any student. Any breach of confidentiality will be carefully reviewed by Pleasanton Unified School District and, if substantiated, may result in the termination of my volunteer involvement with the school district.
Signature *
By typing your name you understand that you are agreeing with the Confidentiality Statement above.
Your answer
Today's Date *
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