EmailMe Form - PCI Volunteer Request

PCI Volunteer Request Form

2020-2021 School Year

All school volunteers must complete this form.

A volunteer is defined as anyone working with children, transporting children, participating in school fieldtrips or helping at a school site or program. The Volunteer Packet will be distributed once this request is received and verified.

The following items are required:
-Completed Volunteer Request Form
-TB Clearance
-Current California Identification or Driver's License (expired licenses cannot be accepted)
-Live Scan (fingerprint and background check from the Department of Justice and/or Federal Bureau of Investigation)

Once the volunteer has completed the fingerprint and background check and all the required documents have been received, HR will notify the volunteer, director and/or site/program leader with an email statement of approval or denial.

**Additional steps are required if you wish to become a volunteer driver.

Legal Name *

First Middle Last

Other Name (Alias)

Nicknames

Phone Number *

### - ### - ####

Email Address *

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

School/Site *

Teacher's Name *

First Last

Student's Name *

First Last

Relationship to Student *

Brief description of volunteer services to be provided. *

Have you ever been convicted of a felony? *

Yes

No

If you answered yes, please explain your conviction:

Do you have any pending charges? *

Yes

No

If you answered yes, please explain your pending charges:

Will you be driving any students? *

Yes

No

If you answered yes, Human Resources will contact you with the additional requirements.