VOLUNTEER APPLICATION

WAKULLA COUNTY SCHOOLS
69 ARRAN ROAD  POST OFFICE BOX 100  CRAWFORDVILLE  FL   32327
850-926-0065  850-926-0123(f)


NAME :  *  *
SOC. SEC. NO. :
ADDRESS :   *
 
  *   *   *
HOME PHONE :
 
WORK PHONE :
  
CELL PHONE :
DRIVER'S LICENSE : * *
E-MAIL ADDRESS :   *
CONFIRM E-MAIL ADDRESS :   *
DATE OF BIRTH :  *
US CITIZEN :
      
GENDER :       *
EMERGENCY CONTACT :
Organization :
School or District Employee :     

Please check all schools that you wish to volunteer at. *




Please check volunteer activities that is of interest to you.  *








Please check volunteer levels that are of interest to you.  *

SCHOOL VOLUNTEER - This position is a volunteer who will serve in the school activities selected above. No additional clearance required for this position. MENTOR - This is a Level II volunteer position and requires specific training and additional clearance. Persons wishing to serve in this capacity should contact Instructional Services at 850-926-0065 after completing this form. ATHLETIC COACH - This is a Level II volunteer position and requires appointment and additional clearance. Persons wishing to serve in this capacity must see the Athletic Director at the respective school. This position is only applicable at Middle and High Schools.

I AM AVAILABLE ON :  *


Monday
           


Tuesday
           


Wednesday
           


Thursday
           


Friday
           


VOLUNTEER ETHNICITY – PLEASE CHECK ONE :


PLEASE CHECK OTHER LANGUAGES WHICH YOU KNOW :

























Volunteer Experience/Talents
  
Languages/Skills or Hobbies :

Legal Disclosure:

If you answered yes to either question A or B below, you must provide, if requested, a written explanation and certified Clerk of Court documents to the District Office for each arrest.  Any volunteer with a criminal record will not be placed unless cleared by the District Volunteer Office.

A. Have you ever entered a plea of Nolo Contendere (no contest), a plea of guilty, been placed in pre-trial intervention program or on probation or been fired in a criminal procedure?

Please Check One :  * 

B.  Have you ever received an adjudication of guilt, had adjudication withheld, had a criminal case result in a nolle prosequi ("nol pros"), or had a criminal record sealed or expunged?

Please Check One :  * 

C. Are you an active or former member of law enforcement, a firefighter, a Department of Children & Family Services employee, a judge, a state or assistant attorney or prosecutor, a government employee with duties involving human resources, labor relations, code enforcement officers or a spouse or child of the foregoing categories?
Please Check One :  * 

Please Check One :  * 

DO YOU HAVE CHILDREN/GRANDCHILDREN WHO ATTEND THE SCHOOL(S) YOU WISH TO VOLUNTEER IN?
Please Check One :  * 

Please Check One :  * 

Please Check One :  * 

Please Check One :  * 

Please Check One :  * 

Please Check One :  * 


Address of Past 5 years :
Dates at this Address Address

Alias and/or married names:
*

List Three (3) References:
Reference Reference Name Email Address Phone Cell Phone
#1
#2
#3
      
Answer Confirmation.... X
   
Please review your answer and check that this is the correct answer that you wish to provide.
 
   

 
Thank you for offering your time, talents and skills to enhance the education of our students.
PLEASE NOTE: Your address and date of birth must be accurate or the clearance process will be delayed.  Personal information must be as it appears on official documents.  All information is confidential. (*indicates required fields)