MSDLT Volunteer Form 2024-2025

MSDLT Volunteer Form 2024-2025

We are pleased to have volunteer support in our programs in MSD of Lawrence Township. We want to do everything reasonable to prepare our volunteers/visitors and maintain safety of the students with whom they will be working. Therefore, we request that anyone visiting or volunteering in the classroom have a background check.

*A NEW Volunteer form will need to be completed EVERY Year

The following named individual would like to be a MSD of Lawrence Township Volunteer/Chaperone.

Volunteer/Visitor Information

Last Name*

Last Name of Visitor/Volunteer

First Name*

First Name of Visitor/Volunteer

Middle Initial

Address*

City*

State*

Zip Code*

D.O.B.*

Email*

Phone*

RACE*

Black

Asian or Pacific Islander

Hispanic

White

American Indian or Alaska Native

Unknown

Gender*

Male/Hombre

Female/Mujer

I agree to MSD of Lawrence Township conducting a thorough background check, including criminal history and sex crimes at no cost to me.*

I understand all information listed and the background check results will remain confidential. The staff involved in this process is the School's Administrative Assistant.*

I understand that I will only be contacted if there are restrictions to my being able to volunteer.*

I hereby authorize MSD of Lawrence Township to perform a criminal background check.*

Reason for the Background Check*

Select

Do you have a student(s) enrolled in LT Schools?*

Select

What school will you be visiting/volunteering?*

Select

How Many?

Select

Student Last Name*

Student First Name*

School*

Select

Student Last Name*

Student First Name*

School*

Select

Student Last Name*

Student First Name*

School*

Select

Send me a copy of my responses

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