VOLUNTEER APPLICATION
Osceola County School District
OASIS
817 BILL BECK BLVD,     KISSIMMEE,   FLORIDA,   34744
407-870-4080  407-870-4018(f)
robin.davis@osceolaschools.net

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

Volunteer may select up to a maximum #5 school.
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.

VOLUNTEER COACH SCHOOL VOLUNTEER OVERNIGHT CHAPERONE

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 :

We occasionally have a need for interpreters or translators. If you speak a language other than English or Spanish and are willing to be included in our "Language Bank:", please select the language(s) that you speak from the list above.

En ocasiones necesitamos intérpretes o traductores. Si usted habla otro idioma además de inglés o español y está dispuesto a ser incluido en el “Banco de Idiomas”, favor de seleccionar el(los) idioma(s) que usted habla.

Please Check One :  * 

Have you ever been convicted, pled no contest, had a record sealed or expunged, been placed on probation, enrolled in a pretrial diversion program or had adjudication withheld in a criminal offense, felony, misdemeanor or otherwise, or are there any criminal charges now pending against you other than a non-criminal or minor traffic violation (DUI/DWI are criminal violations)?

Ha sido alguna vez declarado culpable, se ha declarado no litigante, ha tenido algun record sellado o suprimido, ha sido puesto en libertad condicional, ha sido registrado para un programa de desviacion antes de juicio o ha tenido una sentencia suspendia por un delito criminal, delito grave, delito menor o de otro tipo, o hay algun otro caro criminal pendiente contra used aparte de una infraccion no criminal o una infraccion menor de transito? (DUI/DWI(manejar bajo la influencia del alcohol y/o substancias controldas) son infracciones criminales de transito.
Please Check One :  * 

Volunteer Applicant’s SSN Disclosure Consent Statement

It is the policy of the School District of Osceola County to conduct criminal history background checks for individuals who participate in volunteer activities. As such, the Osceola County School Board will request you to provide your social security number to conduct such check and that, per Florida Bill 7026, a mental health evaluation may be included from law enforcement. I agree and consent to usage of my social security number for such background screening purposes.

Declaración para Dar el Consentimiento de Divulgar el Número de Seguro Social del Voluntario Solicitante

Es política del Distrito Escolar del Condado Osceola conducir investigaciones sobre el historial criminal de personas que participen como voluntarios en actividades. Como tal, la Junta Escolar del Condado Osceola tiene como requisito que usted provea su número de seguro social para conducir tal investigación. Estoy de acuerdo y doy consentimiento de utilizar mi número de seguro social para propósitos de dicha investigación.

Please Check One :  * 
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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

"By submitting my application, I acknowledge and agree that the School District's acceptance of my application shall be subject to a criminal background check, and a search of the sexual predator and sexual offender registration information maintained by the Florida Department of Law Enforcement, as required by Chapter 2004-81, Laws of Florida. I understand that I am offering my services to the School District of Osceola County without compensation. I certify that all information given on this application is true and complete. I understand that any misrepresentation, omission, or incorrect statement of facts called for in this application is cause for immediate dismissal as a volunteer.  As a volunteer, I agree to abide by all School Board rules, regulations and policies."

"Entiendo y convento que la aceptacion por parte del Distrito Escolar de mi solicitud estara sujeta a una verification de antecedentes criminales, y una busqueda de informacion dentro de  los registros de depredadores sexuales y delicuentes sexuales que mantiene el  Departamento de Cuerpos Policiales de la Florida, tal y como lo requiere el Cepitulo 2004-81, de las Leyes de la Florida.  Entiendo que estory ofreciendomis servicios al School Distric of Osceola County sin ninguna compensacion.  Yo certifico que toda la informacion dada en esta solicitud es completa y verdadera.  Entiendo que cualquier tergiversacion, omision o declaracion incorrecta de hechos requeridos en esta solicitud es motivo para mi despido inmediato como voluntario.  Como voluntario, convengo en regirme segun tadas las  normas, regulaciones y politicas de la Junta Escolar."
      
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Thank you for offering your time, talents and skills to enhance the education of our students.

Every Child, Every Chance, Every Day!