Volunteer Application

Volunteer Application
Name

First NameLast Name
Primary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
Address

Street Address

Street Address Line 2

CityState

Zip Code
I anticipate volunteering at the following buildings:
Please any explain any related experiences:
Please provide any information that should be considered when reviewing your application:
Are there any restrictions or conditions of your availability as a volunteer?
Note: Volunteer applicants must provide Federal Criminal History Check, Pennsylvania Criminal History Report (Act 34), and Child Abuse Clearance Statement (Act 151) and clearances must be submitted as part of this application. School visitors are subject to Raptor (or such other building-level security program as may exist) screening. All clearances must be dated within one year of the application. No individual will be approved to serve as a volunteer if any of the required clearances evidence an offense that would preclude such an individual from being employed in Pennsylvania public schools. All applications and clearances shall be maintained for five years.
Have you ever been convicted of or do you have any charges pending for felonies, misdemeanors, and /or ordinance violations other than minor traffic violations?
Please retain a copy of all clearances. You may upload all clearances or, after submitting this form, bring a copy to the school.
- Control Number
- Date of Clearance
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Upload Record Check Certification
  
  Cancelof
- Certificate ID
- Verification Date
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Upload Child Abuse Clearance
  
  Cancelof
- I have been a resident of Pennsylvania during the entirety of the previous ten-year period.
- Registration ID
- Date of Clearance
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Upload FBI Clearance
  
  Cancelof
- Date of Verification
  
  MonthDayYear
  2 digit month, 2 digit day, 4 digit yearDate
- Upload PDE - 6004
  
  Cancelof
- Signature
- Should be Empty: