Southern Door District Volunteer Application

We appreciate your interest in volunteering for the Southern Door School District Volunteer Program. Our district offers a variety of activities you may choose from when volunteering your time. Simply complete and submit a volunteer application and upon approval you will receive instructions on next steps.

It is very important that the information you enter on the application matches your government issued identification card, including your full legal name (including middle). Please DO NOT use nicknames. 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, please be sure there is a current phone number in your application. 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 don't hesitate to contact me at 920-825-7311 or shubbard@southerndoor.k12.wi.us.

Thank you,
Sue Ann Hubbard, 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

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 shubbard@sdsd.k12.wi.us 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

I authorize and consent to having the District conduct a full and complete criminal background check based on the information provided above, and I agree that such authorization and consent includes additional criminal background checks at any time for as long as I continue to volunteer with the District. I understand that any false information, misrepresentation or omission on this statement may result in immediate disqualification for any volunteer service with the District I also acknowledge that I have an obligation for as long as I continue to volunteer with the District to notify the District as soon as possible, but no more than three calendar days after any arrest, indictment, conviction, no contest or guilty plea, or other adjudication for any violation of the law other than minor traffic violations. I hereby release and hold harmless the District, its Board, officers, employees and agents, both past and present, as well as all providers of information, from any liability related to furnishing and receiving information related to my criminal background, including arrests and convictions. Further, I agree to abide by all relevant Board policies and administrative guidelines while serving as a volunteer for the District.

Please note that a disclosed offense will not automatically impact an individual’s ability to volunteer for the District. Decisions in this regard are made on a case-by-case basis and in compliance with all applicable state and federal laws and District policies.

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.