JGESA: Volunteer Application Form
Thank you again for making time for our students. We look forward to seeing you at our school!
Name *
First and last name
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Email *
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Phone number *
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Which position(s) are you interested in? *
Required
If you have selected expert or other, please provide more information here.
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Volunteers agree and commit to do the following:
• Follow district/school policies and procedures

• Comply with all directives of school administrators and staff

• Report any student health or safety concerns to school administrators before leaving the school that day

• Engage in positive and supportive relationships with students

• Respect culture, religion, and lifestyle diversity

• Be respectful of teachers’/coaches’ time constraints and their authority

• Respect students’ dignity

• Be positive role models

• Be good listeners, patient, flexible, and nurturing

• Be non-judgmental and allow students to make mistakes

• Separate personal goals from those of the students

• Respect the confidentiality of students and staff

• Ask for help when needed and follow directions of school staff

• Support, not replace, the role of parents or guardians

• Remain calm, cool, and collected in frustrating and stressful situations

• Reinforce students’ successes

• Overcome setbacks or disappointments

• Be reliable, prompt, and dependable

• Conform to federal and state laws prohibiting discrimination on the basis of race, color, national origin, sex or

disability

Volunteers will NOT engage in any of the following while in their volunteer capacity:

• Share information about students, except with appropriate school personnel

• Recommend or recruit students for non-school-sponsored activities

• Express, promote, or share personal agendas (e.g., religious or political) during their volunteer experience

• Meet with students outside of school and/or school sponsored activities or when directed not to do so

• Make contact with students outside of school, via phone, email, or any social networks

• Use cell phones or cameras to photograph or make videos of students

• Violate school policies and procedures or directives of school employees

• Engage in any illegal activity while volunteering

• Miss scheduled meetings/appointments unless impossible to keep and then will give as much notice as

possible

Volunteer Agreement
I understand that all volunteering relationships established through JGESA programs take place with the student on the school campus, during school hours or at other school authorized activities ONLY.

I also understand that Jane Goodall Environmental Sciences Academy has a zero-tolerance policy with regard to sexual harassment, bullying, drugs and alcohol, and weapons.

*I have reviewed the volunteer handbook (*can be found online on the same page as this application).

I understand that engaging in any of the prohibited conduct outlined above, or violating any laws or District policies or procedures, will immediately disqualify me from volunteering in any District schools, programs, and/or events.

I understand that I cannot recruit or recommend students for non-school sponsored activities, and I cannot express or share personal (e.g., religious or political) agendas with students.

I understand that volunteering is a privilege, not a right, and that JGESA may, in its sole discretion, decide to discontinue any volunteer’s participation at any time and for any reason or no reason, with or without notice or warning.

I have read and agree with the above Jane Goodall Environmental Sciences Academy Volunteer Rules, Requirements and Agreement.

I hereby agree to the above statements and rules set forth by the Jane Goodall Environmental Sciences Academy. (please enter your full name -- this is an electronic signature) *
Your answer
CONFIDENTIALITY AGREEMENT
In consideration for the opportunity to obtain educational and/or practical experience through Jane Goodall

Environmental Sciences Academy (“JGESA”), I, the undersigned program student or volunteer, understand and accept the following conditions and responsibilities:

1. It is my responsibility to become familiar with and abide by the policies, regulations and rules established by the JGESA as posted on the JGESA’s website, as well as any other guidelines provided by the JGESA during the time of the program.

2. I shall not make any direct or indirect use of any JGESA private or confidential information for my own personal gain or for any other purpose other than as required for the program and shall not disclose any private or confidential information to any person.

3. I shall not use the JGESA’s name, logo or any trademark for any promotional purposes, public announcements or disclosure without the written consent of the JGESA.

4. I shall comply with all applicable state and federal privacy laws.

5. I shall not directly or indirectly collect, access, use or disclose private student, parent, volunteer or employee personal information obtained by or provided to me for or to any third party or for any other purpose than in accordance with the program.

6. Should I receive a request for information, I shall immediately forward that request to my JGESA supervisor to handle.

7. I shall advise the JGESA immediately in writing of a breach of privacy of personal information of any JGESA student, parent, volunteer or employee or of a loss of any associated record, and shall take all reasonable and prompt measures to prevent any further breaches or losses.

The provisions herein shall survive the program. By entering my name below I am electronically signing this agreement and I am agreeing to the terms and the conditions outlined.

I hereby agree to volunteer confidentiality agreement by the Jane Goodall Environmental Sciences Academy. (please enter your full name -- this is an electronic signature) *
Your answer
CRIMINAL RECORD HISTORY INFORMED CONSENT FORM
*IMPORTANT: According to district policy, JGESA chaperones must have a onetime background check.

PRE-VOLUNTEER CRIMINAL BACKGROUND CHECK POLICY

The Jane Goodall Environmental Sciences Academy (“JGESA”) will request that applicants for chaperone volunteer positions will be subject to a background check as described in the Minnesota Child Protection Background Check Act, Minn. Stat. §299C.60 et. seq. (“Act”) or other background checks as allowed by law. The offer of employment shall be conditioned upon a determination by the JGESA that an applicant’s criminal history does not preclude the applicant from employment with the JGESA. If an applicant has resided in a state other than Minnesota, s/he will also be requested to consent to a Federal Bureau of Investigation (“FBI”) background check.

In addition, if the JGESA knows or has reason to believe that a current employee or volunteer has a criminal conviction that was not previously disclosed to the JGESA by the current employee or volunteer, that individual will also be requested to consent to a background check(s) as described above. The District specifically reserves any and all rights it may have to conduct criminal background checks regarding current volunteers, applicants, or employees without the consent of such individuals.

Adherence to this policy by the JGESA, its employees and job applicants or others shall in no way limit the JGESA’s right to require additional information or to use procedures currently in place or other procedures to gain information concerning criminal activities of employees and applicants.

Legal Reference: Minn. Stat. §299C.60 et. seq. Policy Adopted: 8/20/2015

My electronic signature below confirms that I have read the District’s Criminal Background Check policy and certify that all the information I have provided on this form is true and complete to the best of my knowledge. I understand that giving false information or omitting requested information could result in rejection of my application or dismissal if I am accepted as a volunteer. *
Your answer
Thank you for your interest in joining our team.
Studies show that parental involvement in a child's education is one of the most important factors in raising student self-esteem and academic achievement. All of us here at Jane Goodall Environmental Sciences Academy appreciate your generous gift of time and attention to help children learn.
Volunteerism means a lot to us...
Next steps:
You will receive an email confirmation of this application. Once you have filled out this form, we will send you a link for a background check.
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