Volunteer Clearance Form
Parent First Name
Parent Last Name
Address (Street, City, Zip)
Date of Birth (Parent Volunteer)
California Driver's License or California I.D. Number
Phone Number (Include Area Code)
School(s) Where You Will Volunteer
Fairlands Elementary School
Hearst Elementary School
Lydiksen Elementary School
Mohr Elementary School
Valley View Elementary School
Vintage Hills Elementary School
Walnut Grove Elementary School
Hart Middle School
Harvest Park Middle School
Pleasanton Middle School
Amador Valley High School
Foothill High School
Village High School
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.
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.
By typing your name you understand that you are agreeing with the Confidentiality Statement above.
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