VOLUNTEER FOR DISTRICT - WATERVILLE SCHOOL DISTRICT : Job Details

CERTIFICATION, AUTHORIZATION AND RELEASE

All of the information I have provided in my application materials is true, correct, and complete. I authorize Waterville School District to make any investigation of any personal, educational, vocational, or employment history. I further authorize any institution or government agency to provide Waterville School District with information they have regarding me. I hereby release and discharge Waterville School District and those prior employers or other references who provide information from any and all liability as a result of furnishing and receiving this information. This information includes the sources cited above and specific examples as follows: the local Washington State Patrol, information from the Federal Bureau of Investigation of either data on all criminal convictions, or certification that no date on criminal convictions are maintained, information from SPI, the Washington or other State Department of Social Services Child Protective Services Unit and any locality to which they may refer for release of information pertaining to any findings of child abuse or neglect investigations involving me. I further agree that if I am employed, I will provide verification of my certification, education, and experience. I agree that information provided by an individual shall be confidential and I shall not have access to such information. I agree that if I have made any omission or have provided false or incomplete statements, the district may, at its sole discretion, without notice or due process procedures, terminate my employment contract. If such action is taken by the district, the contract shall be deemed void from its inception.

I also understand and agree that I may be conditionally employed while the district performs a background record check or while the district awaits the Board of Directors making a final hiring decision as to whether or not I will be employed by the district. I understand that my employment is conditioned on the completion of both the above acts and until such time as they are completed, my employment shall only be as a casual day-to-day employee and will not in any way bind or require the district to continue my employment.

General Questions

* PLEASE CHECK ONE

* IF OTHER ON QUESTION 2 PLEASE STATE BELOW

* NAME OF CHILD IN SCHOOL IF ANY

* HAVE YOU EVER BEEN CONVICTED OF ANY CRIME AGAINST CHILDREN OR OTHER PERSONS?

* HAVE YOU EVER BEEN CONVICTED OF ANY OF THESE FOLLOWING CRIMES? For the purpose of the question convicted includes (1) instances in which a plea of guilty of nolocontendere is the basis of conviction, and (2) all proceedings in which a sentence has been suspended or deferred.

* IF YOU SELECTED ANY CRIME OR OTHER IN QUESTION 6 ABOVE, PLEASE EXPLAIN BELOW: Please give the approximate date of the crime (s) and give a brief explanation.

* HAVE YOU EVER BEEN CONVICTED OF ANY CRIME? (DUI, THEFT, MISDEMEANOR) For the purpose of the question convicted includes (1) instances in which a plea of guilty of nolocontendere is the basis of conviction, and (2) all proceedings in which a sentence has been suspended or deferred.

* IF YOU ANSWERED YES OR OTHER IN QUESTION 7 ABOVE PLEASE GIVE THE APPROXIMATE DATE OF THE CRIME(S) AND GIVE A BRIEF EXPLANATION.

* DECLARATION I declare under the penalty of perjury under the laws of the State of Washington that the foregoing and all information included in the application is true and correct. If the information provided or answer (s) to any question on the Volunteer Background Questionnaire change, I understand that I must immediately notify the Waterville School District. I understand I must answer this application truthfully and completely. Any falsification of deliberate misrepresentation, including omission of material fact, failure to update this background questionnaire, and /or lack of completion of this form can be grounds for denial of a volunteer assignment. Furthermore, I understand that a background check will be processed through the Washington State Patrol per RCW 43.43.834. Checking the yes box below will serve as my electronic signature.

* LIST ALL FORMER NAMES YOU HAVE USED OR BY WHICH YOU ARE KNOWN TO REFERENCE.

* WHAT DEPARTMENT OR TEACHER ARE YOU VOLUNTEERING FOR?

ADDITIONAL INFORMATION

The Town of Waterville, a sunny oasis in North Central Washington State, lies on

US Highway 2 about half way between Everett (north of Seattle) and Spokane. The community is located in wheat country along the Ice Age Floods geological trail. Since its founding in 1889, Waterville, along with the designation of being the Douglas County Seat, boasts a rich history filled with farming, recreation destinations, and diverse economic trends. Waterville maintains its historic feeling as if caught in a wrinkle in time. Many buildings in town are listed on the State and National Historic Registers of Historic Places. Waterville has always been a center for wheat commerce; farming is still a mainstay of the local economy. Descendants of pioneer families preserve the Waterville historic tradition and give the community a sense of stability. Newcomers are always welcome and add much to the vitality of the town.

Waterville School District Mission Statement:

Waterville School's mission is to provide a rigorous, student-centered education by focusing time, energy, and resources to help all students achieve at high levels in a respectful and safe environment.

Waterville School District Vision Statement:

We personalize teaching to create high achieving students who make a positive impact on society.

Waterville School District Belief Statements:

We believe that every student is unique and can learn in an environment that encourages creativity, trust, honesty, and high expectations for all learners.

We believe that improved learning for every student begins with the strengthening of research-based instructional practices in a personalized learning environment.

We believe that student success is ensured when everyone is working toward a clear and common goal to improve teaching and learning, built on the foundation of the Washington State Learning Requirements.

We believe that the Waterville learning community supports improved learning through a collaborative effort between students, staff, families, and community based on mutual respect