Spartanburg County School District Two
3231 Old Furnace Road ∙ Chesnee, South Carolina 29323
Telephone: (864) 578-0128 ∙ Fax: (864) 578-8924
www.spart2.org
Making A Difference For Students Every Day
For Principals
Interaction with Students?
(please initial below)
Yes No
School Approval
For DO:
District Approval
Chaperone/Volunteer Application
Please submit this form to the school along with a picture ID
Full Name_________________________________ Maiden Name__________________________
Address__________________________________________________________________________
City__________________________________ State__________________ Zip code__________
Phone Number: Home_______________ Mobile_________________ Work ______________
E-mail Address______________________________
Date of Birth __ __/__ __/ __ __ __ __ Gender: Male Female
Copy of Picture ID is attached: YES NO
How long have you been a resident in South Carolina? _____________________________________________
Have you ever been convicted of a felony? YES NO If yes, provide date(s) and disposition(s)
_________________________________________________________________________________________
Emergency Contact Information:
Name________________________________ Phone Number_______________________________
Volunteer Preference:
School Volunteer Day Trip Overnight Trip Chaperone
Other_______________________________
School________________________________ Activity & Date of Event__________________________
I certify that the information provided on this application is true and complete to the best of my knowledge, and agree that falsified
information or significant omissions may disqualify me from volunteering in the schools. I give authorization to Spartanburg School
District Two to conduct an investigation into my background and understand that this is part of the requirement prior to becoming a
volunteer. I understand that Spartanburg School District Two will not be responsible for any personal injury or property loss that may
occur to me while performing volunteer services. I also understand that I will not receive any compensation from Spartanburg School
District Two or any entity, group or individual for serving as a volunteer. I also understand that my service as a volunteer is conditional
upon the District’s receipt of a satisfactory background check and submission of a picture ID.
__________________________________________________________________________________________________________________________
Applicant’s Signature Date
__________________________________________________________________________________________________________________________
Principal’s Signature Date
Please complete and return this form with a payment of $26.00 for a background check to your
child's school. Checks can be made payable to the school.
Copy of Picture ID is required.
click to sign
signature
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click to sign
signature
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