Volunteer In Our District

BE A VOLUNTEER IN OUR DISTRICT!

The Pewamo-Westphalia School District values community involvement in the way of volunteering. Whether you'd like to help out in a classroom, attend a field trip, or coach, volunteering is a great way to be involved with the schools and the students in our district.

If you would like to volunteer, please complete a Volunteer Form and return it to the classroom teacher or building secretary where you'd like to volunteer.

You may also choose instead to fill out the online form below, which is automatically submitted to our office staff.

Thank you for your interest in being a volunteer!

Please answer the following questions carefully, correctly, and completely. Thank you.

Full name of potential volunteer Please enter your full first and last names.

School I wish to volunteer with

Name of student you are associated with at the school.

Classroom/teacher you would be volunteering with/for Please name the classroom grade (if elementary) and/or teacher's name you are planning to help by volunteering.

Phone number

Email address

Teacher's Classroom/Event Please add the teacher's name and the name of the event that you are volunteering for.

I represent that (please check ONLY ONE of the two boxes below.)

I have not been convicted of, nor pled guilty or nolo contendre (no contest) TO ANY CRIMES. (If you are in doubt, please check the next box and explain.)

I have been convicted of, or pled guilty or nolo contendre (no contest) to the following crimes. (Please use next section to explain the nature of conviction, date, and court.)

Conviction history information Nature of conviction, date, and court)

I understand and agree that Pewamo-Westphalia Community Schools will conduct a criminal record check through the Michigan State Police.

If the report received from the State Police is not the same as my representation(s) above respecting either the absence of ANY conviction(s) or any crimes of which I have been convicted, I will not be allowed to volunteer in the capacity of a volunteer/chaperone for Pewamo-Westphalia Community Schools.

I may not be allowed to volunteer in any capacity, depending upon the findings of this criminal check.

Legal name Please enter in this order: last, first, middle initial

Any other names used (including maiden name):

Date of birth MM/DD/YYYY

Gender

Race

I understand that the above information is required by the Central Records Division of the Michigan State Police. I authorize the Pewamo-Westphalia Community School District to utilize the above information for the sole purpose of obtaining a background check via the Internet Criminal History Access Tool (ICHAT) with the Michigan State Police and sex offender's registry file search.

Signature Typing your name here indicates your agreement to the submission of this form to the Michigan State Police for the background check.

Today's Date MM/DD/YYYY

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