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Centerville City Schools
2019-20 Academic Volunteer Program

Academic Volunteer Application/Form
for New Community Volunteers

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

Last Namerequired

First Namerequired

Email Addressrequired

Preferred Phone Numberrequired

Example: XXX-XXX-XXXX

Addressrequired

Apt Number

Cityrequired

Staterequired

Ziprequired

In case I have a medical emergency while I am at school, please contact:

Name of Emergency Contactrequired

Phone Number of Emergency Contactrequired

Example: XXX-XXX-XXXX

PVN Volunteer Opportunities

Please check the areas where you would like to help (mark all that apply). Visit www.centerville.k12.oh.us/students-parents/volunteer/positions for more information about each position.

PVN Orientation/Trainings

If you have previously attended any training at PVN, you do not need to attend those sessions again. To help us place you more quickly, please indicate if you have already attended one of these training sessions.

PVS Volunteer Opportunities

Please check the areas where you would like to help (mark all that apply). Visit www.centerville.k12.oh.us/students-parents/volunteer/positions for more information about each position.

Cline Volunteer Opportunities

Please check the areas where you would like to help (mark all that apply). Visit www.centerville.k12.oh.us/students-parents/volunteer/positions for more information about each position.

Driscoll Volunteer Opportunities

Please check the areas where you would like to help (mark all that apply). Visit www.centerville.k12.oh.us/students-parents/volunteer/positions for more information about each position.

Classroom Volunteer Library Volunteer Educational Classroom Project Volunteer Math Pentathlon Volunteer Lunchroom Volunteer Junior Achievement Volunteer (2nd Grade) Short-term Project Volunteer

John Hole Volunteer Opportunities

Please check the areas where you would like to help (mark all that apply). Visit www.centerville.k12.oh.us/students-parents/volunteer/positions for more information about each position.

Normandy Volunteer Opportunities

Please check the areas where you would like to help (mark all that apply). Visit www.centerville.k12.oh.us/students-parents/volunteer/positions for more information about each position.

Stingley Volunteer Opportunities

Please check the areas where you would like to help (mark all that apply). Visit www.centerville.k12.oh.us/students-parents/volunteer/positions for more information about each position.

Weller Volunteer Opportunities

Please check the areas where you would like to help (mark all that apply). Visit www.centerville.k12.oh.us/students-parents/volunteer/positions for more information about each position.

Magsig Volunteer Opportunities

Please check the areas where you would like to help (mark all that apply). Visit www.centerville.k12.oh.us/students-parents/volunteer/positions for more information about each position.

Homework Help/Class Work Review Volunteer Short-term Project Volunteer Chess Club Volunteer Music/Orchestra Volunteer Library Volunteer Learning Center Volunteer Test Preparation Volunteer

Tower Heights Volunteer Opportunities

Please check the areas where you would like to help (mark all that apply). Visit www.centerville.k12.oh.us/students-parents/volunteer/positions for more information about each position.

Noon Hour Helper Chorus Rehearsal/Music Volunteer Short-term Project Volunteer

Watts Volunteer Opportunities

Please check the areas where you would like to help (mark all that apply). Visit www.centerville.k12.oh.us/students-parents/volunteer/positions for more information about each position.

Classroom Volunteer Noon Hour Helper Special Education Classroom Volunteer Band, Orchestra, Piano Accompanist Volunteer

CHS Volunteer Opportunities

Please check the areas where you would like to help (mark all that apply). Visit www.centerville.k12.oh.us/students-parents/volunteer/positions for more information about each position.

Classroom Volunteer Semester Exam Help Noon Hour Help I am only available at specific times during the school year. Please contact me to discuss the opportunities.

CHS Speakers Bureau

There are opportunities for professionals to relate information about their occupations, hobbies or other areas. Since there is no one-on-one interaction with students and the teacher is present, this would not require a background screening. If you are interested in this opportunity, please share your job title and/or area of expertise.

CHS Medical Symposium

Each year, CHS hosts a Medical Symposium for Anatomy/Physiology and Biotech students where healthcare professionals serve on a panel and round table discussions to stimulate interest in pursuing biomedical careers. Since there is no one-on-one interaction with students and the teacher is present, this would not require a background screening. If you are interested in this opportunity, please share your job title and/or area of expertise.

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

Example: XXX-XXX-XXXX

Reference #2 Namerequired

Reference #2 Emailrequired

Reference #2 Phonerequired

Example: XXX-XXX-XXXX

Reference #3 Namerequired

Reference #3 Emailrequired

Reference #3 Phonerequired

Example: XXX-XXX-XXXX

Please check one of the following*

I have a current background screening through Centerville City Schools (issued to substitutes, team managers/coaches, CCS retired staff, CCS employees, etc.). I do not have a current background screening through SecureVolunteer-BIB or Centerville City Schools and agree to enter a request for a criminal background screening online: https://bib.com/securevolunteer/centerville-city-school-district

AVP Policies & Guidelines*

All potential volunteers must check this box before submitting the form.

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!

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Please provide an email address where we can send a link to your current form.

Email Address :