In an era where community involvement in educational institutions is increasingly recognized for its vital contribution to student success, forms such as the People Assisting Local Schools (PALS) Volunteer Application become essential tools in building a solid foundation for such partnerships. This comprehensive application form, created by the Pulaski County Special School District (PCSSD), is designed to facilitate the engagement of enthusiastic volunteers eager to contribute their time and skills to local schools. At its core, the form collects basic personal information including the volunteer’s name, address, occupation, and contact details, ensuring a starting point for background checks and further communications. It delves deeper by inquiring about potential criminal records, specific skills and interests, previous volunteer experiences, and any disabilities that might influence volunteer activities. Crucially, the form offers a selection of volunteer opportunities, allowing individuals to indicate their preferences for roles such as mentor, tutor, or reader, among others, and the school level they are interested in assisting with. Additionally, the application accommodates scheduling preferences, highlighting the program’s flexibility to incorporate volunteer support at convenient times for both parties. Embedded within this process is a mandatory authorization for the release of confidential information from the Arkansas Child Abuse and Neglect Central Registry, underlining the district’s commitment to safeguarding the well-being of its students. This adjunct requirement not only ensures the safety of the children but also reinforces the integrity of the volunteer program. Taken together, the PALS Volunteer Application represents a meticulous approach to assembling a community-based support system for schools, demonstrating the PCSSD's dedication to creating enriching environments for both students and volunteers.
Question | Answer |
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Form Name | Pcssd Pals Form |
Form Length | 2 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 30 sec |
Other names | topresent, Signatureofapplicant, ApplicantsRace, containindicatingtheunde |
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PALSPeople Assisting Local Schools
Volunteer Application
Originating School _____________________________ Date________________
Name: _______________________________________________________________________
LastFirstMiddle
Address: ______________________________________________________________________
StreetCityZip Home phone
Occupation: ___________________________________________________________________
Employer |
Position |
Work phone |
Cell phone: _____________________ |
Have you ever been convicted of, or are you currently being charged with any felony? _____
If yes, please explain: ___________________________________________________________
Special skills & interest: ________________________________________________________
Volunteer experience: ___________________________________________________________
Do you have any disabilities that might affect your involvement? ______________________
Which volunteer opportunities are you most interested: (check all that apply)
_____ Mentor |
_____ Tutor |
_____ Reader |
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_____ Resource speaker |
_____ Clerical/ staff assistance |
_____ Field Trip Chaperon |
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_____ |
School activities |
_____ Recess/ lunch monitor |
_____ Other ___________ |
_____ |
Elementary School |
_____ Middle School _____ Senior High _____No preference |
School (s) preferred: ____________________________________________________________
What time/ day works best for you: (check all that apply) |
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_____ Monday _____ Tuesday _____ Wednesday |
_____ Thursday _____ Friday |
___ Morning ___ Lunch ___ Afternoon ___ Flexible |
___:__ am/pm to __:___ am/pm |
Authorization for release of confidential information to the Pulaski County Special School District
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DQGUHWXUQHGZLWKWKLVIRUP
3$/63HRSOH$VVLWLQJ/RFDO6FKRROV3XODVNL&RXQty Special School District - 925 E. Dixon Road - Little Rock, AR 72206
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Authorization for release of confidential information contained within the
Arkansas Child Abuse and Neglect Central Registry.
I hereby request that the Arkansas Child Abuse and Neglect Central Registry release any information that their files may contain indicating the undersigned applicant as an alleged perpetrator of suspected child abuse/neglect. This information should be addressed to͗
Communications Department Pulaski County Sp ecial School District
925 East Dixon Road
Little Rock, AR 72206
I understand that the name of any confidential informants, or other information which does not pertain to the applicant as alleged perpetrator, will not be released.
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Applicant’s name (print)Maiden name/aliasesSocial Security number
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Applicant’s Race |
Age |
Date of birth |
Driver’s License number |
List your addresses for the last 7 years: |
List all of your children, and any whom you |
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serve as legal guardian, by their full name. |
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Include their date of birth by month/date/year: |
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From __________________to present: |
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From _________________to _____________: |
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From _________________to _____________: |
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From _________________to _____________: |
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Signature of applicant:______________________________ Date: ________________________________________
A notary must complete the following:
County of___________________________) SS
STATE OF ARKANSAS |
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Acknowledged before me, this ____ day of _________,20 ___. |
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My commission expires: |
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Notary Public