Tisdale Middle & Secondary School

Billet Volunteer Application Form

Saskatchewan Student Leadership Conference, September 20 – 22, 2017

We request that this Billet Volunteer Application Form be filled out and submitted ASAP to TMSS. Final deadline is May 31st, 2017

Surname: Date:

Mailing Address: Box: Town: Postal Code:

Physical Address of Home: Street Address or Land Location:

Number of Billets (must be at least 2 billets): Billet Preference: Male Female

Do you have any of the following in or around your residence: Smokers Dogs Cats

Tisdale Middle & Secondary School

306-873-2352

Page 2 of 2 Billet Volunteer Application Form Box 100 800 101st Street Tisdale, SK

http://tmss.nesd.ca

1st Responsible Adult Resident

Name:

Maiden Name:

Birth Date:

Birthplace:

Residence Phone#

Work Phone#

Cell Phone#

Email:

I understand that I am volunteering to billet students in our residence. I agree to provide transportation, breakfast, a place to sleep in a safe environment. I also agree to submit for a Criminal Check by the deadline above.

Signature______

2nd Responsible Adult Resident

Name:

Maiden Name:

Birth Date:

Birthplace:

Residence Phone#

Work Phone#

Cell Phone#

Email:

I understand that I am volunteering to billet students in our residence. I agree to provide transportation, breakfast, a place to sleep in a safe environment. I also agree to submit for a Criminal Check by the deadline above.

Signature______

Tisdale Middle & Secondary School

306-873-2352

Page 2 of 2 Billet Volunteer Application Form Box 100 800 101st Street Tisdale, SK

http://tmss.nesd.ca

List all other residents living in the home (children, boarders, relatives, etc):

Full Name / M/F / Date of Birth / Birthplace / School attending

Billet Volunteer Application Form

Instructions and Checklist

Please check off all the following to finish Billet Volunteer Application Form:

1.  Fill out Billet Volunteer Application form. Be sure you have signature(s) on Page 1

2.  Copy of valid Driver’s License (picture ID) (copying can be done at TMSS)

3.  Copy of valid Health Card (copying can be done at TMSS)

4.  Fill out attached Criminal Check form (Consent for the Release of Police Information) filled out for each Responsible Adult and any other persons over the age of 18 in the household:

a.  Fill out Part 1:

i.  Address should be the Physical Address, not the Box number

ii.  Be sure to include ALL last names you may have had throughout your life

b.  Only Sign and Date Part 2 – Consent

c.  Part 3 – Type of Record Check Required:

i.  Only Initial #1

ii. Only Initial #3

5.  Bring filled out Billet Volunteer Application form, copy of both IDs, and filled out Criminal Check forms for ALL adults in the household to the Tisdale Middle & Secondary Office. ASAP. Criminal Checks take a long time and there will be many checks to do. No Criminal Checks will get done during the summer.

Thank you for your participation.

Tisdale Middle & Secondary School

306-873-2352

Page 2 of 2 Billet Volunteer Application Form Box 100 800 101st Street Tisdale, SK

http://tmss.nesd.ca