Volunteer/Background Check Form

Required

 

VOLUNTEER PLACEMENT & BACKGROUND CHECK FORM

As a prospective volunteer for the Dexter Community School District, I understand that it is the school district’s policy to secure criminal history information as part of the volunteer screening process. All information you provide is treated confidentially and used only for the purpose of securing background check information. This form must be completed and turned in along with a copy of your Driver’s License BEFORE your volunteer assignment begins.

PLEASE ATTACH A COPY OF YOUR DRIVER'S LICENSE AT THE END OF THIS FORM

Namerequired
First Name
Middle (optional)
Last Name
Must contain a date in M/D/YYYY format
Race(Race/Ethnicity categories are defined by the U.S. Government. This information is necessary in order to complete a background check.)required
Must contain a date in M/D/YYYY format
Ex: classroom teacher, coach, etc.
Building or Department where you will be volunteeringrequiredPlease select up to 5 choices
Please select up to 5 choices
Will you be volunteering for more than one event this school year?required
Have you pled no contest to, or been convicted of, a misdemeanor/felony or are there misdemeanor/felony charges currently pending against you?required
Name, Phone Number, Relationship to you.

I understand my services to the Dexter Community Schools are strictly on a volunteer and as-needed basis.  I acknowledge that my volunteer services can be discontinued or terminated by the Dexter Community Schools at any time.  I agree to handle my volunteer services in good faith and represent the Dexter Community Schools in a positive manner by acting professionally and appropriately at all times.  I agree to abide by the all rules and policies of the Dexter Community Schools and acknowledge that Dexter Community Schools does not provide insurance coverage for the volunteer for any loss, injuries, illness or death resulting from the volunteer's unpaid service to the School District.  By signing this form, I waive any claims and release the District of any obligation should I become ill or receive an injury as a result of my volunteer services.  In addition, by signing this form I hereby give consent and acknowledge that the Dexter Community Schools may conduct a criminal history check at any tie through the Criminal Records Division of the Michigan Department of State Police and/or the FBI or any other resource in regards to my volunteer assignment with the District.

(Typing your name in this box gives Dexter Schools permission to run an iChat background check.
Must contain a date in M/D/YYYY format
Attach up to 1 file with a maximum size of 10MB
No file chosen
We are not able to complete a background check without a copy of your license.
Terms of Service
Thank you for offering to volunteer in our District.  If you have any questions regarding this form,  please contact the Human Resources Department at hr@dexterschools.org.