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Volunteer Agreement & Authorization Form


First Name
Last Name
Must contain a date in M/D/YYYY format
Will your volunteer service occur on more than one day?
Check a box to indicate the level of volunteering you are seeking required
Acknowledgement and Authorization
  • I understand that my volunteer services may only commence after the completion of the background-checking process and that my ability to volunteer is contingent on satisfactory background-checking results. 
  • I understand that depending on my level of volunteering I may need an additional criminal record check through the Vermont Criminal Information Center (VCIC) and FBI fingerprinted. If needed, I understand that I will be required to provide releases and other information necessary to complete the checks. 
  • I understand that I will automatically be disqualified from volunteering if my name appears with a substantiated report of abuse or neglect of a child or adult. I also understand that I may be disqualified if I have a criminal conviction which places students at risk. In the event the district receives notice of conviction or receives a substantiated report of abuse or neglect, you will receive written notice of the disqualification and I shall be afforded the opportunity to request a review of the substantiation with the Agency of Human Services (AHS) or with the Vermont Department of Public Safety. 
  • I understand that the VCIC costs associated with my background checks shall be paid to the ANWSD in the amount of $11.25. I also understand that if I do not log any volunteer time during the school year my volunteer status shall be changed to "inactive". Inactive volunteers must begin the process again before returning.
  • I understand that it is the responsibility of the Superintendent or their Designee to accept or deny individuals as volunteers, and all decisions related to the continued service of a volunteer's service. I further understand that the decisions of the Superintendent or their Designee on these matters are final. 
  • I understand that I am an unpaid volunteer and not an employee of ANWSD.
  • I understand that all ANWSD students have the right to privacy. I also understand that it is not appropriate for me to share information about students with members of my family or the public. 
  • I also understand that if a student discloses to me any reports of abuse or neglect whether in or outside of school I will immediately report this information to the classroom teacher or principal. 
Agreement of Termsrequired