District Volunteer Application

We appreciate your interest in volunteering for the 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. If you are unable to provide an email address, you may use the district’s email address. All information collected on the application will remain confidential and will not be shared outside the volunteer program.

You must provide a copy/proof of a current cleared TB Test (TB Tests are valid for 4 years). TB testing is at the expense of the volunteer. If you have any questions about the application, please speak to your School Office Manager.

Thank you,
Centralia Elementary School District

Personal Information

Personal Information

Phone number is required
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 receptionist@cesd.us and a district administrator will call you regarding the status.
School Preferences

Please select the schools at which you wish to volunteer


Please select the functions from the list below. (select all that apply)



The following documents are required by the state to authorize clearance within this school district.  Your TB test can be uploaded as an image from your phone or a PDF.  If you have difficulty with uploading your TB document, you can bring it into the School Office Manager for verification.


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


As a chaperone, I agree to do the following:

· Follow the direction of any teacher or administrator involved with this event.

· Ride the bus or any other transportation in which the students I am chaperoning are riding.

· Supervise no more than the specific number of students I am assigned (i.e. eight (8) students per chaperone).

· Follow the trip itinerary.

· Stay with my designated students at all times.

· Not bring other children on the trip.

· Not smoke during the trip.

· Not consume alcohol during the trip.

· Not use illegal drugs during the trip.

· Not be on my cell phone, unless an emergency.

· Not engage in inappropriate or sexual contact, have sexual conversations, or other inappropriate conversations with any minor or student.

· Not allow students to engage in sexual conduct with other students.

· Follow all school rules and policies.

· Ensure that students follow all school rules and policies.

Each volunteer is expected to maintain confidentiality regarding each student and family. If volunteers hear about or observe evidence of child abuse, volunteers will report the information to the site principal or designee immediately. Volunteers understand that their service activities as a volunteer are determined by the administrator and/or teacher and may be discontinued at any time.

I understand that if I violate any of the conditions outlined herein, I will be denied the privilege of chaperoning. I also understand a District or Site Administrator has the right to deny me the privilege of chaperoning for any reason at any time. I have read and understand the information above. I agree to follow these and other guidelines set by the District.

By providing your signature, you are agreeing to abide by the rules and regulations of the District Volunteer Program. 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.

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 the school office manager.