District Volunteer Application

Dear Volunteer,

Welcome! We are glad you have chosen to become a member of our Mountain Home School District Volunteer Team. Every high achieving school district has one thing in common….strong parental support.

Volunteers aid in completing a spectrum of services needed to help every child reach his or her potential. Over the years, our volunteers have helped children learn to read, master difficult mathematical and scientific concepts, and have boosted children's self-confidence. Working together, volunteers and teachers can provide students with more individual attention while serving as positive role models.

Thank you for your valuable gift of time and energy and your commitment to public education.

Sincerely,

Dr. Jake Long

Superintendent

Personal Information

Legal First Name

Address Line 1

Legal Middle Name

Address Line 2 / Apt # / Building #

Legal Last Name

City

Maiden Name

State

Gender

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 bjones@mhbombers.com and a district administrator 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)

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 MY SIGNATURE, I CERTIFY THAT I KNOW, UNDERSTAND, AND AGREE THAT ANY FALSE STATEMENT OR OMISSION OF INFORMATION REQUESTED WILL RESULT IN MY TERMINATION AS A SCHOOL VOLUNTEER.

I give my consent for JD Palatine to conduct a criminal background record search on myself and release any results to the following entity: Mountain Home Public Schools, 2465 Rodeo Drive, Mtn. Home, AR 72653

Name

Signature

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

Thank You

Once your application is submitted, JD Palatine will conduct a criminal background check screening. You will receive an e-mail from noreplay@raptortech.com of your status. If your background check is cleared and approved, it is important to print the e-mail for your records. If your background check is in question, you will receive an e-mail notification stating the screening is under further review. If your background check is under further review, a School Resource Officer will be in contact with you via email and/or phone if needed.