Volunteer Clearance Form

Thank you for your interest in volunteering in our schools. Please read the notes below and complete the form:

- This form must be completed yearly by each individual who wishes to volunteer with BRSSD to either volunteer for the first time or to update their volunteer status.

- Each volunteer registering must provide a unique phone number during this process, this will be used to track your volunteer status at BRSSD going forward. The same phone number may not be used by two volunteers.

- You must use your full LEGAL First and Last Name in the required fields

- This form must be completed yearly but if you have completed the 'Livescan' background check process for the District since Spring 2016, you DO NOT need to complete that portion of the volunteer process again.

Your first and last name as they appear on your driver's license. This is your LEGAL NAME, if you use a nickname you can include it in the "Nickname" field below.

Volunteer Legal Name*
Nickname
Date of Birth*
Please add your date of birth here.
Volunteer Address*

You will be contacted at the email address you provide.

Volunteer Phone Number


Please provide a unique phone number below, we will use this number to reference your volunteer record going forward.  

A unique phone number must be used for EACH volunteer within our database, we suggest using a personal cell phone number or number that does not change frequently. 

Please follow the format XXX-XXX-XXXX. This number must be unique. If you provide a unique number in the proper format but receive an error message please contact your school site office.

Emergency Contact


In the event of an emergency the person below will be contacted on your behalf.

Emergency Contact*
Please follow the format XXX-XXX-XXXX.
What is your relationship with BRSSD?*
Pick the option that is most relevant below.
How many students do you have attending within the District?*
What sites do you plan to volunteer at?*
Pick all that are relevant.
How many times do you expect to volunteer every month?*

TB Verification


Note: Individuals who plan to volunteer at a school site and are in contact with students 3 or more times a month will be required submit one of the following.



Verification Type

Years Valid

Required Steps

TB Risk Assessment Questionnaire
4 Years

The TB questionnaire (See below for a copy) can be completed by your healthcare provider.

TB Skin Test (TST) or Blood Draw
4 Years

Copy of a negative TB Skin Test (TST) or TB Blood Test.

X-Ray Assessment (Positive Only)
----------

If you have tested positive for TB and can provide a negative X-Ray, an assessment is no longer required.


Either form of TB verification can be uploaded below, you must submit your TB verification to successfully submit the form. If you do not have your verification ready you can "Save and Resume Later" at the bottom of the form. 


Click here for a copy of the TB questionnaire.



Please select the type of TB verification you have completed.

Please pick the type of test or assessment you have completed.


Please enter the date you successfully completed a TB Assessment or Test.

This is the date you sucessfully completed your TB Risk Assessment Questionaire, TB Skin Test (TST), or TB Blood Test. This MUST be the date you completed the assessment, not the date you are submitting this form.


Please upload a copy of your completed TB Assessment, Negative TB Test, or TB X-Ray Assessment.

No File Chosen
File uploads may not work on some mobile devices.

Volunteer Level Information

There are three volunteer levels within the District. In accordance with Board Policy 1240 and California Education Code, fingerprinting is required for volunteers who may have direct contact with students in unsupervised settings. If you will possibly serve as a level 2 volunteer this year, we recommend that you be fingerprinted. 

Level 1
Level 2

Volunteers working under the constant direct supervision of a school district employee.

These volunteers do not need fingerprinting.

The District may perform a Megan's Law check, as well as seek clearance with the local law enforcement.

Volunteers working under the general supervision of a school district employee, and volunteers who will be alone working with or mentoring students

Fingerprinting is required for Level 2.  

Fingerprints will be retained by the CA DOJ and searched against other fingerprints on file, including latent prints.  Applicants have the right to obtain a copy of criminal history record, if any.  Applicants have the right to challenge the accuracy and completeness of their criminal history record, and to obtain a determination as to the validity of their record before the agency makes a final determination concerning their eligibility for volunteering.

The District may also perform a Megan's Law check, as well as seek clearance with local law enforcement.

Examples:

- Classroom volunteer
- Art-In-Action
- Multicultural day
- Discovery Day
- Ralston Wal-About
- Lunch distribution
- Middle school dance chaperone
- Parking lot (drop-off/pick-up)
- Music
- Mystery reader


Examples:

- Afterschool tutor
- Playground supervision
- Escorting students
- Bookfair
- Field trip chaperone
- Afterschool clubs


Volunteers are required to complete a TB questionnaire or provide proof of a negative TB test when volunteering 3 or more times a month.

Are you currently employed by the School District?*
Pick one of the above options.

You have indicated that you are currently employed by the School District, current district employees do not need to complete a background check. If your employment ends with the District and you wish to continue volunteering, you may be subject to a Livescan background check at that time.

Please choose the highest level of volunteering you would like to be cleared for in the future*
Pick one of the above options. If you choose Level 2, fingerprinting is required. Fingerprints will be retained by the CA DOJ and searched against other fingerprints on file, including latent prints. Applicants have the right to obtain a copy of criminal history record, if any. Applicants have the right to challenge the accuracy and completeness of their criminal history record, and to obtain a determination as to the validity of their record before the agency makes a final determination concerning their eligibility for volunteering..
Have you completed the Livescan background check process in the past specifically to volunteer at BRSSD? If not do you wish to complete the process as is required for BRSSD's Volunteer Level 2?*

You DO NOT need to complete the Livescan process an additional time if you have already completed it once as a volunteer. The District will attempt to match your volunteer information with your previous Livescan submission. If we have any difficulty doing so we will reach out to you for further information or request that you complete the process at another time.

Additional Process REQUIRED: Level 2 will require you to complete a Live Scan fingerprint background check*. You can download a copy of the form at this link. You will be responsible for the Live Scan Fingerprint Fee. If this cost would be a financial hardship and you need assistance to cover the cost, please see the "Hardship Livescan Fee Waiver" below.



The Livescan process can be completed at any of the locations found here using the form provided in the link above (You MUST use this form.). The processing fees are $47 plus a rolling fee (the rolling fee will vary per location, see the previous link for the rolling fee cost.). You should retain a copy of your Livescan form for your records.


If you would like more information on what a Live Scan fingerprint background check* is, please visit this link.  

*Fingerprints will be retained by the CA DOJ and searched against other fingerprints on file, including latent prints.  Applicants have the right to obtain a copy of criminal history record, if any.  Applicants have the right to challenge the accuracy and completeness of their criminal history record, and to obtain a determination as to the validity of their record before the agency makes a final determination concerning their eligibility for volunteering.

Hardship Livescan Fee Waiver:
We don't want this cost to be a barrier to any parent volunteer. If this would be a financial hardship and you need assistance to cover the cost, please check the above box. The district will review your request and send you information on how to complete your fingerprinting without charge.
ATI Date of Printing - Hardship Waiver Only - Staff
Livescan OK? - Staff
Volunteer Notified of Clearance - Staff
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