District Volunteer Application

We appreciate your interest in volunteering for the North Polk 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. 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 request to speak with a volunteer representative.

Thank you,

Lynette Foster

District Volunteer Coordinator

515-984-3400  extension 2012

Personal Information

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

Statement of Confidentiality for School Volunteers

I understand in the course of my association as a volunteer with the North Polk Community School District I share the responsibility of maintaining the confidentiality of any student or employee information that may be available to me.  I understand that it is my responsibility to assure rights and confidentiality of information both written and verbal. 

As a volunteer, I will work with the highest standards, committed to the idea that my work will benefit students. I promise to take to my work an attitude of open-mindedness, willingness to learn, as well as interest and commitment. 

I understand that in the performance of my duties, I am not to discuss academic or other confidential information regarding students or employees with anyone. Any breach of confidentiality will be carefully reviewed, and, if substantiated, could result in termination of volunteer involvement with the North Polk Community School District.

I acknowledge that I have read and understand this statement of confidentiality.

Release of Liability and Indemnity Contract

In consideration of being allowed to act as a Volunteer at no cost to the North Polk Community School District, whereby my child and/or other children may enhance their education, I do hereby release and forever discharge the North Polk Community School District, and all students of the North Polk Community School District from any and all claims, demands, actions, causes of action and suits at law or equity arising out of or in any way connected with the Volunteer Program of the North Polk Community School District and my presence in or on School District property. 

I further agree that I enter this Volunteer Program of my own free will, to serve without pay, understanding that I am not an employee or agent of North Polk Community School District and therefore I am not covered by any of its accident insurance and therefore I assume all responsibility for any injury accident or illness that may occur to me during my volunteer service and release the North Polk Community School District, its Board of Directors, agents, and employees, from any and all liability from the same, and hereby agree to indemnify them and save them harmless for any sums that they, or any of them, may be required to pay on my account.

This release and indemnity is given voluntarily and knowingly with full understanding of its meaning and with my full consent to be legally bound.

Waiver Release for the State of Iowa Criminal History Record Check

I hereby give permission for the above requesting official to conduct an Iowa Criminal history record check with the Division of Criminal Investigation (DCI). Any criminal history data concerning me that is maintained by the DCI may be released as allowed by law.

Please enter your payment information

A criminal background check is required and there is a fee associated with the screening.
Fees may vary depending on the functions selected. Payment is necessary to complete your volunteer application.

Thank You

Your volunteer application has been successfully submitted and will be reviewed per the North Polk 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 your volunteer representative, Lynette Foster at 515-984-3400 extension 2012.