Volunteer Application and Consent Form
It is the policy of Whitnall School District to conduct criminal background checks of all individuals seeking to serve as volunteers who work one-on-one, alone with students, who accompany students on overnight activities, or who, at the discretion of the Superintendent or his/her designee, supervise students in an activity with limited oversight by school staff. (See School Board Policy 353.1 School Related Volunteers) The information provided below will only be used to conduct such background check. All information must be provided.

Access volunteer responsibilities here: https://docs.google.com/document/d/1Gx8YvAHu0esIyQXHkc7cbdq6kZimZEFQknSpPV0qhRY/edit

ALLOW AT LEAST FIVE BUSINESS DAYS TO PROCESS

Email address *
Last Name *
Your answer
First Name & Middle Initial *
Your answer
Maiden/Other Names (if none, write N/A) *
Your answer
Street Address *
Your answer
City, State, Zip *
Your answer
Phone Number *
Your answer
Gender *
Date of Birth *
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Volunteer Type *
Event Type *
Event Date *
Your answer
Please check any and all schools where you may volunteer: *
Required
CONSENT
All information provided is true and correct to the best of my knowledge. I understand that misrepresentations or omissions may be cause for rejection or may be cause for subsequent dismissal as a volunteer.

I voluntarily and knowingly:
- authorize any government agency, its officers, employees, and agents to release any and all information regarding my criminal history to the Whitnall School District, its officers, employees, and agents.
- fully release and discharge, absolve, indemnify, and hold harmless such agency, its officers and agents from any and all claims, liability, demands, causes of action, damages, or costs, including attorneys fees, present or future, whether known or unknown, anticipated or unanticipated, arising from or incident to the disclosure or release.

By signing below, I understand the information contained above, am aware of current School Board Policy 353.1, and agree to the Volunteer Responsibilities.

Signature *
Your answer
Today's Date *
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