District Volunteer Application

Thank you for your interest in becoming a volunteer with Centennial School District. Volunteers are an integral part of the classroom and we encourage parents and community members to get involved. Before starting your application, please review the below information and the guidelines outlined in CSD Policy 916 for Visitors and Volunteers by clicking HERE.

It is very important that the information you enter on the application matches your government-issued identification card including your full legal name. It is important that you provide a valid email address so you can be notified as to the status of your application and for future communication. If you are unable to provide an email address, you use the district’s email address. All information collected on the application will remain confidential and not be shared outside the volunteer program.

If you have any questions about the application, please request to speak with a volunteer representative.

Thank you,

District Volunteer Coordinator

Personal Information

Legal First Name

Address Line 1

Legal Middle Name

I don't have a middle name

Address Line 2 / Apt # / Building #

Legal Last Name

City

Maiden Name

State/Province/Region

Gender

Postal/Zip Code

Date Of Birth

Phone Number Phone number is required

Affiliation

Please note: An email will be sent to the email address entered to inform you of the status of your application. If you do not have access to email, please enter volunteer@centennialsd.org, and a district representative will call you regarding the status.

Please select the schools at which you wish to volunteer

Please select the functions from the list below. (select all that apply)

Documents

What paperwork do I need to complete in order to volunteer?

Volunteer Disclosure Form - All volunteers must have a Volunteer Disclosure form on file with the Human Resources Department.
Act 114 FBI Federal Criminal History Report - (online registration through IdentoGo) The Service code for DHS service code is: 1KG6ZJ.
Act 151 Child Abuse History Clearance - Free for initial application or every 57 months for volunteers (Online registration)
Act 34 State Police Criminal History Report - Free for initial application or every 57 months for volunteers (Online registration)
TB Test - All volunteers who are in direct contact with students 10 or more hours per week must submit the results of a TB test in accordance with the Pennsylvania Department of Health.

What paperwork do I need to complete for Student Teaching/Observation?

Act 114 FBI Federal Criminal History Report - (online registration through IdentoGo) (The Service code for Pennsylvania PDE School Districts is: 1KG6XN)* Make sure to choose Pennsylvania Department of Education
Act 151 Child Abuse History Clearance
Act 34 State Police Criminal History Report
TB Test - Direct contact with students 10 or more hours per week must submit the results of a TB test in accordance with the Pennsylvania Department of Health.
Act 24 Arrest/Conviction Report & Certification Form (PDE-6004)

What paperwork do I need to complete for Senior Experience?

Act 114 FBI Federal Criminal History Report - (online registration through IdentoGo) (The Service code for Pennsylvania PDE School Districts is: 1KG6XN)* Make sure to choose Pennsylvania Department of Education
Act 151 Child Abuse History Clearance
Act 34 State Police Criminal History Report

Please select the organization(s) on behalf of which you are volunteering (if not applicable, select "None")

Please read the disclaimer below and provide your signature

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.

Name

Signature

By signing your name you agree to all the above statements. Use the mouse or touch screen to sign.

Thank You

Your volunteer application has been successfully submitted and will be reviewed per the district’s volunteer policy. In the near future, you will be notified as to your volunteer status. If you have any questions, please request to speak with a volunteer representative.