Fillable VOLUNTEER DISCLOSURE FORM

Fill Online, Printable, Fillable, Blank VOLUNTEER DISCLOSURE FORM Form

Use Fill to complete blank online OTHERS pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

VOLUNTEER DISCLOSURE FORM

On average this form takes 7 minutes to complete

The VOLUNTEER DISCLOSURE FORM form is 2 pages long and contains:

  • 2 signatures
  • 14 check-boxes
  • 15 other fields

Country of origin: OTHERS
File type: PDF

BROWSE OTHERS FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
VOLUNTEER DISCLOSURE FORM
Volunteer Coordinator, please return this form to Community Schools Office with a copy of applicant’s Washington, or other state, Driver’s
License or other Official** Photo ID card. Copy front and back of ID card, increase size to 120%, use ‘photo’ setting on your copier.
PRINT ON BLUE PAPER
Operations: Rev Feb 2018
Volunteer Disclosures Must be Renewed Every Two Years.
Today’s Date: _________________________
Photo ID
(see NOTE on reverse)
No. State
Pursuant to Wa. RCW 43.43.830, a criminal history background
check is required by law and will be requested from law
enforcement. Fingerprinting may be required at the discretion of
Central Kitsap School District. CKSD reserves the right to conduct
other background investigations.
Your volunteer opportunity with CKSD is contingent upon the background check.
PLEASE TYPE OR PRINT CLEARLY IN BLUE OR BLACK INK
First
Middle
Last
Mailing Address Street or PO Box
City
State
Zip
Date of Birth:
(Month-Day-Year)
Home Phone
Place of Birth (City and State)
Email Address
Any other name(s) you have gone by (include maiden name)
ANSWER YES OR NO TO EACH QUESTION BELOW
Yes
No
Have you ever been convicted* of any crime against children or other persons? (See reverse, note 1, for
more information)
Yes
No
Have you ever been found by a court in any dependency proceeding to have physically or sexually
abused or exploited any minor or vulnerable adult? (See reverse, note 2, for more information)
Yes
No
Have you ever been released from prison or jail for any drug-related offense, or have you been
convicted* of any offense that involved drugs?
Yes
No
Have you ever been convicted* of any crime? (Felony, Misdemeanor, or Unclassified)
Check “yes” even if your conviction was later dismissed.
Yes
No
Are any criminal charges currently pending against you?
Yes
No
Are you presently charged with, but not convicted* of, any crime?
All “Yes” answers require additional information. If you answered “yes” to any of the questions above, attach
supplemental information providing details. Include any court records. Answering “Yes” does not automatically disqualify
you from volunteering. Falsified information may disqualify you from volunteering even if the event alone may not have been
disqualifying.
By signing this disclosure you, the applicant, certify that you understand the foregoing statements and that you have answered
truthfully and correctly. Furthermore, you understand that a background check will be conducted and you agree to that
background check.
Applicant Signature Date
Parent/Guardian Signature (if applicant is under 18) Date
Administrator approval is required if a volunteer is under age 21. Approved? Yes No
Administrator Signature Date:
List school(s) where you would like to volunteer
click to sign
signature
click to edit
click to sign
signature
click to edit
VOLUNTEER DISCLOSURE FORM
Volunteer Coordinator, please return this form to Community Schools Office with a copy of applicant’s Washington, or other state, Driver’s
License or other Official** Photo ID card. Copy front and back of ID card, increase size to 120%, use ‘photo’ setting on your copier.
PRINT ON BLUE PAPER Operations: Rev Feb 2018
Note 1
Have you been convicted of any crime against children or other persons?
Aggravated murder; first, second or third degree murder; first or second degree kidnapping;
first, second or third degree assault; first, second or third degree assault of a child; first, second
or third degree statutory rape; first or second degree robbery; first degree arson; first degree
burglary; first or second degree manslaughter; first or second degree extortion; indecent
liberties; incest; vehicular homicide; first degree promoting prostitution; communication with a
minor; unlawful imprisonment; simple assault; sexual exploitation of minors; first or second
degree criminal mistreatment; child abuse or neglect as defined in RCW 26.44.020; first or
second degree custodial interference; malicious harassment; first, second or third degree child
molestation; first or second degree sexual misconduct with a minor; patronizing a juvenile
prostitute; child abandonment; promoting pornography; selling or distributing erotic material
to a minor; custodial assault; violation of child abuse restraining order; child buying or selling;
prostitution; felony indecent exposure; or any of these crimes as they may be renamed in the
future?
Note 2
Have you been found by a court in any dependency proceeding to have physically or sexually
abused or exploited any minor or vulnerable adult?
Under RCW13.34.030(2), in any domestic relations proceeding under Title 26 RCW, in any
protection proceeding under Title 74 RCW, or in any disciplinary board final decision.
Disclosure Expiration
Volunteer disclosure forms must be resubmitted for approval every two years.
* “Convicted” means:
All adverse dispositions, including a finding of guilty, a plea of guilty or nolo contendere, an
Alford plea, a stipulation to the facts, a deferred or suspended sentence, a period of probation,
or a deferred prosecution.
** Official Photo ID -- What is an “Official Photo ID”?
Some examples are: State-issued ID cards, State/Private College/University ID cards, Federal-
issued ID cards such as Resident alien ID card, Passport, Tribal enrollment or identification card,
other state, federal, or local government issued identification card as long as it meets the
following criteria:
1. Display the holders photo
2. Display an issue date and expiration date
3. Displays the holders full name
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

VOLUNTEER DISCLOSURE FORM

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 18 February 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document