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Teacher/Administrator's Name - Please Print |
Teacher/Administrator's Signature |
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Date |
Class/Program |
****************** Site Office Use Only: Site Administrator must sign approval. ******************
(Signature) Copy to: Human Resources Department Copy to: CSEA President after approval |

| Full Legal Name | |||
| (Last Name) | (First Name) | (Middle Name) |
| Present Address: | |||||
| Street | Apt. # | City | State | Zip | |
If you have lived in your present address for less than five years, please provide your previous addresses: |
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| Previous Address: | |||||
| Street | Apt. # | City | State | Zip | |
| Email Address: | Phone #: | Cell #: |
| Are you over 18? | Yes No | Sex: | M F |
Additional Data: |
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| 1) Do you have a Valid California Driver's License? No Yes | License #: |
| 2) Are you currently a regular or substitute employee of the Metropolitan Education District? Regular Substitute No |
| School Site/Department | Bldg. No. | Room No. |
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My signature below certifies that all statements made on this application
are true and complete to the best of my knowledge. If approved to volunteer
for the Metropolitan Education District, I understand that any misrepresentation of
factual information contained herein may be cause for removal. Signature Date |
Documentation Required:1. Current Tuberculosis (TB) Skin Screening (No more than 60 days old.) |

| I. |
Education Code Sections 35021 and 35021.1 prohibit persons who are required to register as
sex offenders under Penal Code Section 290 from volunteering in public schools. Penal Code
Section 290.95 requires all persons who are required to register as sex offenders to report
such status when applying for or accepting a volunteer position in schools.
I declare under penalty of perjury under the laws of the State of California that
I have not been convicted of a crime that requires me to register as a sex offender
under Penal Code Section 290, and if I am subsequent to this date convicted of such a
crime, will immediately notify MetroED, Department of Human Resources,
of such conviction. Executed on , , at , California
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| II. |
Release for the Safety of our students:Is there a criminal charge, felony or misdemeanor currently pending against you? No Yes |
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| III. |
Criminal History Check – Please Read Carefully Before Signing: I authorize Metropolitan Education District (MetroED) to make any inquiry of or receive information from any person or organization regarding my suitability for volunteering and do hereby give permission to these persons or organizations to provide such information. I authorize MetroED to submit the criminal history check to the Department of Justice and I hereby release said agency and MetroED, its agents and employees from any and all liability or responsibility arising from furnishing such information. I understand that the application and the records become the property of the District which reserves the right to accept or reject them. In consideration of MetroED's review of this application, I release MetroED and all providers of information from any liability as a result of furnishing and receiving such information. My signature below certifies that all statements made on this application are true and complete to the best of my knowledge. If approved to volunteer for the Metropolitan Education District, I understand that any misrepresentation of factual information contained herein may be cause for removal.
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| School Site/Program | Name of Volunteer | ||
| School Site Address | Telephone |
| Site Administrator Signature: | Date: | ||
| HR Director Signature: | Date: |
| Criminal History Check Clearance: | Live Scan Form #: | Date: | TB Clearance: | ||||
Budget Number to be charged: |
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| 0 | 5832 | 00 | 0000 | 0000 |

| NAME: |
(Please Print) |
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Person(s) to contact in case of emergency: |
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| Name | Relationship | |||
| Address | Day Phone | |||
| Alternative Phone | ||||
| Name | Relationship | |||
| Address | Day Phone | |||
| Alternative Phone | ||||
| Name of Physician | Insurance Carrier | |||
| Physician's Address | Medical # | |||
| Phone | ||||
| Name (Please Print) | Emergency Phone Number
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| Signature | Date | ||
| School Policies to be Reviewed with Volunteer: | ||||||||||||||||||||||||||||||||||||
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I have provided the volunteer with information regarding their assignment, safety, student privacy, security, school policies, and accessible areas in school. The volunteer has been scheduled for a criminal history check with the District Office. I will insure that the criminal history check is complete prior to allowing unsupervised access with any student. Administrator's Signature Date *Return to Site Administrator to be maintained in secure, confidential file and to Volunteer |

Volunteer's Name - Please Print |
Volunteer's Signature |
Date |
| cc: | Volunteer School Site/Department Volunteer Files Department of Human Resources |


| 1. | Submission to the conduct is explicitly or implicitly made a term or condition of a student's academic status or progress |
| 2. | Submission to or rejection of the conduct by a student is used as the basis for academic decisions affecting the student |
| 3. | The conduct has the purpose or effect of having a negative impact on the student's academic performance or of creating an intimidating, hostile, or offensive educational environment |
| 4. | Submission to or rejection of the conduct by the student is used as the basis for any decision affecting the student regarding benefits and services, honors, programs, or activities available at or through any MetroED (District) program or activity |
| 1. | Unwelcome leering, sexual flirtations, or propositions |
| 2. | Unwelcome sexual slurs, epithets, threats, verbal abuse, derogatory comments, or sexually degrading descriptions |
| 3. | Graphic verbal comments about an individual's body or overly personal conversation |
| 4. | Sexual jokes, derogatory posters, notes, stories, cartoons, drawings, pictures, obscene gestures, or computer-generated images of a sexual nature |
| 5. | Spreading sexual rumors |
| 6. | Teasing or sexual remarks about students enrolled in a predominantly single-sex class |
| 7. | Massaging, grabbing, fondling, stroking, or brushing the body |
| 8. | Touching an individual's body or clothes in a sexual way |
| 9. | Impeding or blocking movements or any physical interference with school activities when directed at an individual on the basis of sex |
| 10. | Displaying sexually suggestive objects |
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Print Volunteer Name |
Signature |
Date |

| 1. | Educational Purposes: I will restrict my use of the MetroED's access
to the Net to educational purposes related to my assigned duties within
MetroED and in ways which are reasonably related to the District's
adopted curriculum and educational policies. I will not use MetroED's
Net access for any illegal or immoral purpose. In this regard,
I will not use MetroED's Net access in any manner which would constitute computer hacking,
violation of copyright laws, violation of trade secrets or licenses, or invade another's privacy. |
| 2. | Social Media: I will not use MetroED's Net access for personal use of social media
except during non work time such as break or lunch. Social media means any online platform
for collaboration, interaction, and active participation, including, but not limited to,
social networking sites such as Facebook, Twitter, YouTube, LinkedIn, MySpace, WordPress,
or blogs. Official district social media platform is a site authorized by the Superintendent
or designee. Teachers shall obtain approval from the Superintendent or designee before creating
an official classroom or club social media platform. The social media platforms for teachers
must meet the guidelines under AR 1114. Social media and networking sites and other online platforms shall
not be used by district employees to transmit confidential information about students,
employees, or district operations. |
| 3. | Commercial Uses: I will not use MetroED's Net access for private commercial purposes
or for personal financial gain unless I have obtained permission to do so
from the Superintendent or Superintendent's designee. |
| 4. | Pornography and Hate Materials: I will not use MetroED's access to access, send, or
print material which is obscene, pornographic, or which dominant appeal is for sexual arousal.
Nor will I use MetroED's Net access to access, send or print material, which advocates hate or
violence against others based on their race, national origin, gender, religion, age, disability,
or sexual preference. Nor will use MetroED's Net access to access, send, or print material,
which provide information, which could be used in the production of
destructive devices such as bombs, explosives, or fireworks. |
| 5. | Other Prohibited Activities: I shall also refrain from using abusive or profane language in either public or private messages sent on MetroED's Net access; from using the system to harass, insult, or attack others; from posting anonymous messages on the system; from using encryption software; from vandalizing the data of another user; from gaining unauthorized access to resources or files; from identifying myself with another person's name or password or using an account or password of another user without proper authorization; from theft or vandalism of data, equipment, or intellectual property; from introducing a virus or otherwise improperly tampering with the system; from degrading or disrupting equipment or system performance; or from using MetroED's Net access to invade the privacy of another. |

| 6. | Supervision of Students:
I will provide reasonable supervision and instruction to students under my authority
when they are using MetroED's Net access. In doing so I will reasonably attempt to see
to it that students adhere to their responsibilities under the Student Internet/Network/
Computer Acceptable Use Agreement (E 6163.4) which each has signed. Only those students that sign the
agreement along with their parent or guardian will be permitted to use MetroED's Net access.
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| 7. | Email Access: I will not use my email for retention purposes. All
email will be automatically deleted by the IT department 90 days from the date sent or
received. If it is necessary to retain an email for more than 90 days, email must be
moved to another folder (AR 4040.1). Emails that are determined to have a lasting
value should not be stored in the email Inbox or Sent Items folders; be saved on MetroED's NAS server; and be
printed and maintained in hard copy format, if needed. |
| 8. | Exclusive Net Access at Work: I agree the primary access to the Internet
while I am on school property will be MetroED's Net access, unless I obtain
permission from my supervisor or district level administrator. However,
the District understands the design of Smartphone technologies allow for direct
Internet connection built within Smartphones and iPads or similar devices. |
| 9. | No Expectation of Privacy: I agree that if I use the Net through MetroED
access, that the district may monitor my use of MetroED Net Access and may also examine
all system activities that I participate in, including but not limited to e-mail, voice,
and video transmissions, to ensure proper use of the system. I thereby waive any privacy
expectation I may have with the District to any communications
I transmit or receive through use of MetroED Net Access. |
Print Volunteer Name |
Signature |
Date |

| 1. | All users must use all software in accordance with its license agreements
and the MetroED Use of Copyrighted Materials Policy (AR 6162.6). All users acknowledge
that they do not own this software or its related documentation, and unless expressly authorized by the software
publisher, may not make additional copies except for archival purposes. |
| 2. | MetroED will not tolerate the use of any unauthorized copies of software or fonts
in our organization. Any person illegally reproducing software can be subject to civil
and criminal penalties including fines and imprisonment. All users must not condone
illegal copying of software under any circumstances and anyone who makes, uses, or
otherwise acquires unauthorized software will be appropriately disciplined. |
| 3. | No user will give software or fonts to any outsiders including clients, customers,
and others. Under no circumstances will software be used within MetroED that has been
brought in from any unauthorized location under MetroED‟s policy, including, but not
limited to, the Internet, the home, friends and colleagues. |
| 4. | Any user who determines that there may be a misuse of software within the organization
will notify the Information Technology department. |
| 5. | All software used by the district on district-owned computers will be purchased through appropriate procedures (AR 3300). |
Print Volunteer Name |
Signature |
Date |

| To: | MetroED Volunteer |
| From: | MetroED Program Director |
| Date: | |
| Subject: | Welcome |
It is a pleasure to officially welcome you as a MetroED Volunteer. MetroED recognizes that community volunteers can make valuable contributions to the educational program. We are looking forward to you becoming a part of the MetroED Volunteer Team now that you have passed the required criminal history check and TB screening. The following information is provided to ensure you are aware of the process for continuing to volunteer in the future and while on campus. | |||||||||||||||
| 1. | A Volunteer Application must be completed for each school year. (A criminal history check is
not required if one has already been performed, and the TB test is only required every four (4) years.) |
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| 2. | Volunteers must wear a District identification badge at all times. |
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| 3. | The District Volunteer Registration and Acknowledgement must be completed and on file with the Human Resources
Department. |
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| 4. | Volunteers may not:
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| 5. | Volunteers are to serve as positive role models at all times. A school volunteer must always:
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| 6. | For liability reasons, volunteers must leave preschoolers or children not registered in the school, at home. |
| 7. | Classroom volunteers must be continually supervised and monitored by the teacher or program administrator.
They are not authorized to take over supervision of a classroom unless there is a short-time emergency need. |
| 8. | Volunteers MUST keep confidential any information about a student or any school-related incident.
If there is a safety concern or an emergency issue, it must be immediately communicated to someone in authority. |
| 9. | Volunteers should notify the site administrative office if an illness or injury prohibits
them from attending a scheduled volunteer shift. Volunteers should be prompt and dependable. |
| 10. | Volunteers are covered by the District's Workers Compensation
Insurance while performing their District-approved volunteer duties. |
| 11. | The dress code for volunteers should be appropriate at all times. |
| 12. | Volunteers and staff members must adhere to District policies and procedures regarding volunteers. |
| 13. | Program Directors may set additional procedures/regulations with respect to volunteer involvement. |
| 14. | A volunteer's involvement may be terminated at any time, either at the discretion of the program Director or the volunteer. |