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Centerville City Schools
2018-19 Academic Volunteer Program

Application and Volunteer Information Form
for New Community Volunteers

IMPORTANT! If you are a parent/guardian of a current student or if you have been an Academic Volunteer in Centerville Schools within the past five years, please complete our form for Parents and Returning Volunteers.

Last Namerequired

First Namerequired

Email Addressrequired

Preferred Phone Numberrequired

Addressrequired

Apt Number

Cityrequired

Staterequired

Ziprequired

Name of Emergency Contactrequired

Phone Number of Emergency Contactrequired

Multi-lingual Skills

Please indicate any foreign language(s) in which you are fluent and would be willing to provide assistance to students who do not speak English.

Present or Previous Employerrequired

Occupationrequired

Select the highest level attained*

High school graduate Some college courses College graduate

College Degree or Major (if applicable)

Special Training

Please list any special areas of interest or skills you would like to share.

Why are you interested in volunteering?required

How did you hear about the Academic Volunteer Program?required

Please provide the names, emails and telephone numbers of three references (business or personal, but not relatives).

Reference #1 Namerequired

Reference #1 Emailrequired

Reference #1 Phonerequired

Reference #2 Namerequired

Reference #2 Emailrequired

Reference #2 Phonerequired

Reference #3 Namerequired

Reference #3 Emailrequired

Reference #3 Phonerequired

Please check one of the following*

I have a current background check through Centerville City Schools (issued to substitutes, coaches, part-time or full-time employees, etc.). I do not have a current background check through SecureVolunteer-Background Investigation Bureau (BIB) or Centerville City Schools and agree to enter a request for a background check.

I understand and agree to abide by the guidelines and policies as stated in the Centerville City Schools' Academic Volunteer Program Volunteer Handbook as well as the Centerville City School District Bylaws and Policies.

Note: The handbook is available for download from www.centerville.k12.oh.us/students-parents/volunteer. Printed copies are also available from the AVP district office. The Bylaws and Policies may be accessed from www.centerville.k12.oh.us/about-us/board-of-education.

Please ensure that you have completed all required fields and then click on Submit. Thank you for your interest!

Centerville City Schools2018-19 Academic Volunteer Program

Application and Volunteer Information Formfor New Community Volunteers

Centerville City Schools
2018-19 Academic Volunteer Program

Application and Volunteer Information Form
for New Community Volunteers