Volunteer Application Please print clearly

Name:

Date of Birth (needed for background check): Phone:

OK to text

Address:

Email Address: Secondary Phone:

City/State/Zip:

Please indicate the buildings you would like to volunteer (check all that apply): Early Childhood Program (Birth -5 years) Riverside Academy (Area Learning Center) in Cambridge CPS (Cambridge Primary School) IPS (Isanti Primary School) CIS (Cambridge Intermediate School) IIS (Isanti Intermediate School)

Student Name

Grade

Teacher

IMS (Isanti Middle School) CMS (Cambridge Middle School) CIHS (Cambridge-Isanti High School) SFAS (School for All Seasons) MNC (Minnesota Center) ABE (Adult Basic Education)

School

Cambridge-Isanti Schools has two different levels of volunteering options in our schools, each requiring a different type of background check, free or paid.

By initialing here, you indicate you want a free background check to be completed. Passing this background check will only allow you to volunteer supervised by a Cambridge-Isanti Schools employee in a classroom, during school hours, or from home. The free background check is good for one year. A paid background check can be added anytime during the school year.

By initialing here, you indicate you want a paid background check to be completed. Passing this background check will allow you to volunteer in any of our volunteer opportunities, during or outside of school hours, including field trips. The paid background check is good for three years and paid for and completed online at a cost of $10. I have already completed a paid background check with Cambridge-Isanti Schools within the past three years, am a district employee, or have successfully completed another paid background check in the past 12 months and able to provide a copy of background check.

Over for more information.

Some of the most frequent volunteer opportunities include: PTO/PTO Minutes

Picture Day

Field Trip

Activity Night/ Dance/Party

Process Box Tops

Commencement

Colate Papers

Vision/hearing Screening

Book Fair

Tutoring

Typing/Work from Home

Classroom Helper

Please indicate additional areas you are interested in volunteering your time, or hobbies and interests you have that you would like to share:

Volunteer Confidentiality Agreement

Confidentiality regarding our students, their parents, and our colleagues is of the utmost importance. Student data is classified as confidential under Minnesota and Federal law. This means you cannot share information you learn about a student through your role as a volunteer with anyone else, other than those who “need to know”, such as the child’s teacher or other School District staff. There are times when you may inadvertently overhear conversations that are intended to be confidential. If you should overhear such conversations, it is your responsibility to keep such information confidential. Please be very cautious of things you say about students or family situations at all times. As volunteers you have a special responsibility. Like school staff you may NOT share information about students, families and school staff except with others on a “NEED TO KNOW” basis. This includes students’ parents. If a parent asks you about a student at school, even if it is their own child, you must refer them to the classroom teacher. I understand my responsibility to protect student data and all other confidential information I obtain through my role as a volunteer and take my role as a volunteer very seriously. I certify that the information provided above is true and correct to the best of my knowledge and belief. I understand that Cambridge-Isanti Schools will request a background check on me pursuant to the Minnesota Child Protection Background Check Act.

Volunteer Signature:__________________________________ Date:__________

Revised 09/28/2016

VOLUNTEER FORM.pdf

Riverside Academy (Area Learning Center) in Cambridge CMS (Cambridge Middle School). CPS (Cambridge Primary School) CIHS (Cambridge-Isanti High ...

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