GLPS Volunteer Form (SY 17-18)
Thank you for your interest in volunteering. Keeping our students, faculty and staff safe is a top priority. In order to ensure this safety, and in accordance with the National Child Protection Act (NCPA), Grand Ledge Public Schools, requires all person providing a volunteer service for the district or at any function conducted by the district, to undergo a background check prior to providing a volunteer service.

Completing this form provides your consent for Grand Ledge Public Schools to conduct a background check through the Michigan State Police Internet Criminal History Access Tool (ICHAT) system.

Email address *
Name / Previous Names
FIRST Name *
Your answer
Middle Initial *
Initial only please!
Your answer
LAST Name *
Your answer
Maiden Name / Previous Names (N/A if not applicable) *
Your answer
Demographic Information
Race *
Sex *
Date-of-Birth *
Please be sure to provide the correct year.
MM
/
DD
/
YYYY
Street *
Your answer
City *
Your answer
Zip *
Your answer
Contact Number *
Your answer
Disclosures
Have you been convicted of, or pled guilty or nolo contenders (no contest) to any crimes (misdemeanor or felony)? If you choose "I have been" please list those items you have been convicted of or pled guilty to below. *
List all crimes (misdemeanor or felony) you have been convicted of, pled guilty or nolo contenders (no contest) to.
Your answer
Our Commitment to Student Safety
Grand Ledge Public Schools reserves the right to approve or deny any volunteer service upon review of the background check returned through ICHAT. The determination will be based upon the individual’s fitness to have responsibility for the safety and well-being of children. Providing false information, or information contradicting the background check information, is grounds for immediate volunteer denial.
Digital Signature *
Checking the box below represents your acknowledgment the information above is correct and your acceptance of this volunteer registration form.
Required
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This form was created inside of Grand Ledge Public Schools.