Volunteer Application Form

BP: https://muroc.k12.ca.us/board_of_trustees/board_policies/community_relations/volunteer_assistance

ONLINE MVP APPLICATION

MUROC JOINT UNIFIED SCHOOL DISTRICT
17100 Foothill Avenue
North Edwards, California 93523
760-769-4821

VOLUNTEER APPLICATION FORM (Printed Version)

Name:

Telephone:

Address:

Social Security #:

Driver's License #:

Please answer "yes" or "no" to the following questions:

Have you ever been convicted of, admitted to, or are you under official investigation for any of the following:

1. a felony
2. a sex offense
3. child abuse
4. a violent crime
5. a controlled substance offense*

*if admitted to or under official investigation for, did this occur within one (1) year from the date of last usage
*if convicted, did this occur within the past five (5) years

Is there anything the Board should be aware of in considering your application?

I understand that the information given will only be used by school officials and law enforcement authorities. I declare, under penalty of perjury, that the above statements are true and correct.

Signature:

Date:

Note: ALL VOLUNTEERS on school sites or in a shared location with students at any time are required to submit fingerprints through the Live Scan system. The District shall provide the applicant with a Live Scan request form and a list of nearby Live Scan locations.

All volunteers are required to prove that they are free from active tuberculosis. A chest x-ray will only be required if the intradermal tuberculin test is positive.

Proof of TB results may be checked by the school district nurse or the medical office where the test was administered.

Please print the application and Certificate of Completion and bring them to your health care professional: 
Click here- TB RISK ASSESSMENT APPLICATION AND CERTIFICATE 

AFTER COMPLETION, THIS FORM IS TO BE SENT TO THE PERSONNEL OFFICE.

Information verified by:

School:

If you plan to drive a district vehicle for school events please complete District Registration and DMV Release of Driver Record Information forms. You can access these forms from the District website: www.muroc.k12.ca.us, District Forms, Admin Regulation 3541.1, Transportation for School-Related Trips.

Rev.12/2021

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