Mexico Academy & Central School District Volunteer Application

We appreciate your interest in volunteering for Mexico Academy & Central 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 via email.

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, please use Volman@mexicocsd.org. 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 contact Stacey Rohling at (315)963-8400, ext. 5400.

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 VolMan@Mexicocsd.org 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 providing your signature, you are agreeing to abide by the Volunteer Code of Conduct. 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.

MEXICO ACADEMY AND CENTRAL SCHOOL DISTRICT STUDENT PRIVACY AND CONFIDENTIALITY AGREEMENT FOR SCHOOL VOLUNTEERS

I acknowledge that I have read, understand, and will comply with the Confidentiality Statement below:

I will not discuss the content of any student information which was learned in the course of or because of my volunteer work in the school; nor will I disclose student education records, academic standing, financial status, disciplinary information, attendance, physical/mental health information or personally identifiable student information with anyone except the child’s teacher or Principal.

Concerns or questions regarding student records or issues of confidentiality will be brought to the attention of the school administrator.

I shall perform tasks only under the supervision and guidance of appropriate staff, and I understand that am expected to comply with all District rules and regulations.

I understand that violations of these guidelines may constitute cause for termination of my services.

I agree to abide by the Volunteer Code of Conduct.

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. Once approved by the Board of Education, we kindly request that you come to the District Office to watch our on-line Volunteer Training Video and pick up your Handbook. If you have any questions, please request to speak with our volunteer representative, Stacey Rohling, At (315)963-8400, ext 5400