By providing your signature, you are agreeing to abide by the rules and regulations of the District Volunteer Program. One or more of the volunteer activities you have selected may require you to provide your United States social security number so we can perform a criminal background check. Your social security number will only be used for this purpose and we do not retain this information.
You also are agreeing that you have never been...
A. Convicted of any crime against children or other persons (aggravated murder; first or second 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 rape of a child; 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 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.
B. Found in any dependency action or by a court in a domestic relations proceeding or in any disciplinary board final decision to have physically or sexually assaulted, exploited or abused any minor.
C. Released from prison
D. Convicted of any offense that involved drugs/alcohol
E. Convicted of any felony other than those listed above in part A in Washington or any other state
F. Presently charged with, but not convicted of a crime
Pursuant to RCW 9A.72.085, I certify under penalty of perjury under the law of the state of Washington that this information is true and correct. I understand that this offer to volunteer within the Freeman School District #358 is contingent upon an acceptable response from the Washington State Patrol and/or federal law enforcement agency, whose criminal history review will be sought of all applicants on an annual basis. I agree that Freeman School District, at its discretion, preclude me from volunteer service, if, among other reasons, I provide misleading or incomplete statements. I am aware that I will receive no compensation for my services.