Name of Volunteer __________________________________________________ Period of Time for which request is being made ____________________________ Position for which services shall be rendered ______________________________ Name of Teacher/Coach/Sponsor supervising class, activity, sport: ___________________________________________________________________ Address: ____________________________________________________________ Phone Number: _______________________________________________________ Date of Birth (mandatory) __________________________ This request, upon approval, is good only for the current school year and must be resubmitted for subsequent school years. I, ___________________________________, agree to the Miami-Yoder School District JT-60 conducting a criminal background check and any or all future requirements for the same. I also agree to conduct myself in a manner respectful of district policies and decorum. Signed: _________________________________________ …
Read Full Policy- Last Reviewed/Revised:
- Last Adopted: September 11, 2008