Perry Central School District Volunteer Application

We appreciate your interest in the Perry CSD 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. 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. 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 reach out to the Main Office staff at 585-237-0270.

Thank you!

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

Preferred Language (for future communications)

Please note: An email will be sent to the email address entered to inform you of the status of your application.

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

My electronic signature permits the District to contact any or all references listed if necessary. In addition, my signature indicates I have received a copy of the Code of Conduct either in person or online at www.perrycsd.org and I will abide by the Perry Central School District Code of Conduct. I understand that one or more of the volunteer activities I have selected may require me to provide your United States social security number so the District can perform a criminal background check. I understand my social security number will only be used for this purpose and the District does 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!

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.