Fillable Volunteer Application Form printable pdf download

AMESTOWN

REA

CHOOL

ISTRICT

Volunteer Application

School Year: _________________________

I am applying to be a Level I, Level II or Level III volunteer in the Jamestown Area School District.

Level I - Assistive Volunteer: Any individual who voluntarily provides services to the school district, without

compensation, and who: (1) works directly under the supervision and direction of a teacher or administrator

employed by the district; and (2) does not provide direct services to students or have unsupervised contact with

students. Examples of assistive volunteers include homeroom parents/guardian; individuals who volunteer to as-

sist in the planning or conducting of classroom celebrations; concert or performance ushers; and individuals who

help manage, officiate or perform functions ancillary to an athletic event or extracurricular activity.

Level II - Independent Volunteer: Any individual who voluntarily provides services to the school district,

without compensation, and who: (1) works under the general direction and supervision of a teacher or adminis-

trator employed by the district; and (2) provides direct services to students or may, from time to time, have or may

be reasonably expected to have unsupervised contact with students. Examples of independent volunteers include

volunteer tutors, chaperones for overnight field trips, and individuals who volunteer to provide counseling or

health related services to students and field trips

Level III - Volunteer Coaches/Sponsors: any individual who voluntarily provides services to the school dis-

trict, without compensation, and who: (1) works under the general direction and supervision of a coach or student

activity sponsor employed by the district; and (2) directly supervises or instructs students engaged in the activity

or may, from time to time, have or may be reasonably expected to have unsupervised contact with students. Exam-

ples of volunteer coaches/sponsors include individuals who volunteer to serve on the coaching staff of an athletic

team; volunteer athletic trainers or equipment managers; and choreographers, musicians and other individuals

who provide instruction to students in the marching band or school musical.

Name:

_____________________________________________________________________________

Address:

_____________________________________________________________________________

Phone:

_____________________________________________________________________________

q I certify that I have lived in Pennsylvania for 10 years AND swear I have never been convicted of a disqualify-

ing crime in Pennsylvania, or the corresponding offenses under the laws of any other jurisdiction. (See page 3 for

the list of disqualifying crimes)

Applicant Signature: ___________________________________________ Date: ___________________

Volunteer Application Form