MARION COUNTY PUBLIC SCHOOLS

VOLUNTEER PROGRAM

Thank you for making the difference in our schools as a volunteer.

Your time and talents are very much appreciated.

Follow these steps:

1.  Please complete the attached application, (do NOT leave any blank spaces).

2.  Return the application to the Board of Education, any Marion County public school or the Community Education Director @ 214 North Harrison Street, Lebanon.

3.  The process could take anywhere between 7-28 days.

4.  You may contact 699-3906 for information, questions or concerns about your background check.

5.  All information received will be kept personal and private and will not be released for any other purpose.

MARION COUNTY PUBLIC SCHOOLS

DISTRICT VOLUNTEER APPLICATION

(FORM MUST BE COMPLETE)

Location(s) you wish to volunteer: Marion County High_____

St. Charles Middle_____Lebanon Middle_____Lebanon Elementary_____

Calvary Elementary_____Glasscock Elementary_____West Marion Elementary_____

PLEASE PRINT

Name______

First Middle Maiden Last

Address______

House# Street OR P.O. Box

______

City State Zip

Social Security #______Date of Birth______

Phone #______Work #______Cell #______

E-mail Address______

Education (circle last year completed): 6 7 8 9 10 11 12 13 14 15 16 17+

Grade School High School College Graduate School

Presently Employed: Yes______No______

If employed, where? ______Full time Part time

Parent_____ Guardian_____ Grandparent_____ Other (specify)______

School-age children:

Name______School______Teacher______

Name______School______Teacher______

Name______School______Teacher______

Name______School______Teacher______

Have you ever been arrested for a felony? Yes_____ No_____

If so, when______and explain:______

______

How long have you been a KY resident? ______

If less than one year, what was your previous address? ______

Check which of the following you are interested in participating:

Consistent Volunteer (in school/with students on a regular basis) Event Chaperone (field trips, dances, etc.)

What event or reason are you volunteering in our schools?______

______

Conditions of Commitment

As a volunteer:

·  I will attend any necessary orientation meetings.

·  I will submit to a cost free background check.

·  I realize that if given any information that involves the safety of an individual, it must be shared with immediate supervisor.

·  I will abide by all school rules and Board of Education regulations/policies that apply to me.

·  I will honor my commitment to volunteer as scheduled.

·  I understand that if I share confidential information, I may be released from my volunteer position.

·  I understand that the school principal or designee has the responsibility to assign and/or dismiss volunteers as needed.

·  I understand that any information seen/heard while volunteering shall remain confidential.

Signature Date

All information given on this form will remain confidential. Completion of this form does not commit you or the sponsoring organization to a volunteer position.