Volunteer Background Check Form

**CONFIDENTIAL FORM**

LAKELAND SCHOOL CORPORATION

CONSENT TO PERFORM NON-EMPLOYMENT BACKGROUND CHECK FOR VOLUNTEERING ACTIVITIES

I consent to have Lakeland School Corporation perform a background check in compliance with Lakeland School Corporation’s board policy #8120 for volunteer services. I understand the information obtained through the background check will be kept confidential.

I agree to release, indemnify and hold harmless Lakeland School Corporation and any agency used by Lakeland School Corporation with regard to any information provided by the agency.

I understand that Lakeland School Corporation will only use the information provided to complete the necessary background check relative to my volunteer status as required by board policy #8120. A copy of policy #8120 appears on the reverse side of this document.

I hereby certify that the information provided in the consent form is true, correct and complete.

PERSONAL INFORMATION – REQUIRED

  • Please enter a value between 9 and 9.

OPERATIONS – POLICY #8120

LAKELAND BOARD OF SCHOOL TRUSTEES
VOLUNTEERS

The School Board recognizes that certain programs and activities can be enhanced through the use of volunteers who have particular knowledge or skills that will be helpful to members of the staff responsible for the conduct of those programs and activities.

The Superintendent shall be responsible for recruiting community volunteers, reviewing their capabilities, and making appropriate placements. The Superintendent shall not be obligated to make use of volunteers whose abilities are not in accord with Corporation needs.

Each volunteer who is in direct contact with students will be required to submit a Limited Criminal History Record Check.

Each volunteer who is in isolated direct contact with students will be required to submit to an Expanded Criminal History Record Check which shall include:

A. National criminal history check (as defined by I.C. 20-26-2-1.5) of the criminal
history record system maintained by the Federal Bureau of Investigation based on
fingerprint identification or another method of positive identification;
B. Search of the national sex offender registry maintained by the United States
Department of Justice;
C. An Indiana Bureau of Motor Vehicles driver history if the position involves driving.

The procedures shall ensure that information and records obtained from criminal history inquiries under this policy are confidential and shall not be released except as necessary to implement this policy or to defend a decision made pursuant to this policy.

The Superintendent is to inform each volunteer that s/he:

A. Shall agree to abide by all Board policies and Corporation guidelines while on duty as
a volunteer;
B. Will be covered under the Corporation’s liability policy but the Corporation shall not
provide any type of health insurance to cover illness or accident incurred while
serving as a volunteer, nor is the volunteer eligible for workers’ compensation.
C. Will be required to report any personal arrests on the filing of criminal charges while
serving as a volunteer.

The Superintendent shall also ensure that each volunteer is properly informed of the Corporation’s appreciation of his/her time and efforts in assisting the operation of the schools.

1st Adopted: 11/5/2007
Revised & Adopted: 11/15/2010
© NEOLA 2010