HDMS Helping Hands Volunteer Form

Please complete the form below. Required fields marked with an asterisk *

First Name, MI., Last Name*

Answer required for "First Name, MI., Last Name"

Email 1

Answer required for "Email 1"

Phone Number*

Number Required

What is the name of the Business/Organization at which you are currently employed?

Answer required for "What is the name of the Business/Organization at which you are currently employed?"

Business Office Phone Number

Number Required

Work Experience

Business Name/Address. Immediate Supervisor/Phone No. Dates of Employment

Answer required for "Work Experience"

Personal References

Name. Address. Phone Number.

Answer required for "Personal References"

Volunteer Experience

Business/Organization/Address. Immediate Supervisor/Phone Number. Dates of Volunteer Service.

Answer required for "Volunteer Experience"

I am able to commit 30 minutes to 1 hour per week during this school year to tutor a student in:*

Answer required for "I am able to commit 30 minutes to 1 hour per week during this school year to tutor a student in:"

Reading/Literacy

Math

Other:

I would prefer to volunteer on the following days:*

Answer required for "I would prefer to volunteer on the following days:"

Monday

Tuesday

Wednesday

Thursday

Friday

Other:

Time Preference (Mornings)

Specify the time during the morning you prefer to serve as a volunteer; e.g., 9 am to 10:30 am

Answer required for "Time Preference (Mornings)"

Time Preference (Afternoons)

Specify the time during the afternoon you prefer to serve as a volunteer; e.g., 12:15 pm to 1:30 pm

Answer required for "Time Preference (Afternoons)"

School(s) at which you prefer to work*

Answer required for "School(s) at which you prefer to work"

HDMS

Supervisor's name at preferred school

Answer required for "Supervisor's name at preferred school"

Preferred Grade

Answer required for "Preferred Grade"

6th

7th

8th

Please read carefully. When done, clcik the attestation block below.

1. I understand I must receive discrimination and harassment training before working with students and parents/guardians.

2. I will hold in confidence any information revealed to me pertaining to any student.

3. I will report any home or school concerns about a child to the principal or the child’s teacher before I leave for the day.

4. I understand that I have a legal obligation to report any suspected abuse or neglect that is revealed to me by a child to the principal or designated person.

5. I will not contact a child off campus or remove him/her from the school at any time.

6. I will not accompany a child into the restroom.

7. I will call the school office as soon as I know when I have to be absent.

8. I have read the school handbook and will abide by the professional dress code.

9. I understand that a criminal record check will be conducted before I am allowed to volunteer.

10. I understand I must provide a valid (not more than 3-years old) fingerprint criminal history investigation report with this application before it can be considered. Fingerprint criminal history investigations may be obtained from the Sheriff’s Office and I also understand that I am responsible for the cost of this criminal history check. I further understand that I will not be allowed to perform any volunteer duties until this requirement is satisfied.

Attestation*

Answer required for "Attestation"

I have read, understand, and will comply with the above requirements.

I HAVE NOT been convicted of a felony, and I have not been charged or convicted of any offense involving drugs, alcohol, child abuse, sexual deviation, or moral turpitude.*

Answer required for "I HAVE NOT been convicted of a felony, and I have not been charged or convicted of any offense involving drugs, alcohol, child abuse, sexual deviation, or moral turpitude."

I attest that the above is true.

I HAVE been convicted of a felony, charged or convicted of an offense involving drugs, alcohol, child abuse, sexual deviation, or moral turpitude.

Answer required for "I HAVE been convicted of a felony, charged or convicted of an offense involving drugs, alcohol, child abuse, sexual deviation, or moral turpitude."

Yes. I have a criminal history.

Criminal history disclosure and explanation of the offense(s).

Answer required for "Criminal history disclosure and explanation of the offense(s). "

Criminal Background Investigation Release Form

The purpose of this form is to notify you that a criminal records check will be conducted on you in the course of consideration for volunteer service with Cherokee County Schools. Criminal Background disclosures or results more serious than a misdemeanor will disqualify you as an applicant. The school's principal may require you to complete a criminal background investigation release form prior to you being qualified to serve as a school volunteer.

Please complete the following information.

Personal Identification Information

Answer required for "Personal Identification Information"

First Name, Middle Name, Last Name*

Answer required for "First Name, Middle Name, Last Name"

Social Security Number*

Answer required for "Social Security Number"

Date of Birth*

Answer required for "Date of Birth"

Age*

Answer required for "Age"

Driver's License Number

Answer required for "Driver's License Number"

State of Issue of Driver's License

Answer required for "State of Issue of Driver's License"

Present Address*

Include Street, city, state, & zip code

Answer required for "Present Address"

County--City--State and dates in which you have lived in the past 10-years*

Example: Polk County, Turtletown, TN, 2020-2023. Macon County, Franklin, NC, 2023-2025

Answer required for "County--City--State and dates in which you have lived in the past 10-years"

Signature of Applicant*

Signature Required

Please fix the highlighted areas below before submitting.

HDMS Helping Hands Volunteer Form