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IT TAKES A VILLAGE KINDERGARTEN VOLUNTEER FORM
It Takes A Village Kindergarten appreciates the hard work and commitment of all our volunteers. Our volunteers assist with the program and/or the students in administrative, curricular or extra-curricular activities. A current (less than 3 years old) Consent for Disclosure of Criminal Record Information (CPIC) is required before a volunteer position can be confirmed. It Takes A Village Program Coordinator manages this Disclosure of Criminal Record Information for all prospective volunteer’s and grants security clearance following receipt. This report is generated following completion of the Consent for Disclosure of Criminal Record Information at the Cochrane RCMP detachment. Two (2) pieces of identification and a personal letter from It Takes A Village Kindergarten are required at time of consent. Application must be made in person.
Your compliance with this policy enables It Takes A Village Kindergarten to comply with insurance requirements and to provide a safe environment for the children. The information collected on this form will be held in strict confidence in compliance with the Personal Information Protection Act (PIPA) issued by the Government of Alberta and with the It Takes A Village’s PIPA policy. Please complete page 2 of this form and return it to the Program Coordinator prior to September 30th. Please note that page 2 allows for the signatures of 1 to 2 volunteers; the number of volunteers per E.C.S child is in no way limited. If you have any questions about this form or require more forms, please contact the Program Coordinator.
As a volunteer, we would like to advise you of the following:
1. Confidentiality is of the utmost importance in the school setting in order to ensure the rights, dignity and worth of students, parents, volunteers and school staff is honored.
2. You must notify the Program Coordinator of any new criminal charges at the time the charge is made.
3. Rocky View Schools has a NO SMOKING policy on school grounds. As the kindergarten building is on Rocky View property we also are bound to the policy.
4. The Teacher is responsible for student learning and discipline.
Please inform the Teacher of preference for volunteering whether you are more comfortable with being hands-on with the children or cutting and pasting etc.
Name of student at It Takes A Village Kindergarten: ______
Volunteer #1
Do you have a criminal record for which you have not received an official pardon? Yes / No
Have you completed a security clearance application (Consent for Disclosure of Criminal Record Information)? Yes / No
By signing this volunteer form, I am agreeing to the conditions outlined above and agree to provide a CPIC prior to September 30th of the current year.
Printed
Name of Volunteer:______
Signature: ______Date: ______
Signature of Volunteer’s Parent/Guardian is required if Volunteer is under 18 years of age.
Printed Name of
Parent/Guardian:______Signature: ______Date: ______
Volunteer #2
Do you have a criminal record for which you have not received an official pardon? Yes / No
Have you completed a security clearance application (Consent for Disclosure of Criminal Record Information)? Yes / No
By signing this volunteer form, I am agreeing to the conditions outlined above and agree to provide a CPIC prior to September 30th of the current year.
Printed
Name of Volunteer:______Signature: ______Date: ______
Signature of Volunteer’s Parent/Guardian is required if Volunteer is under 18 years of age.
Printed Name of
Parent/Guardian:______Signature: ______Date: ______
(Revised April 2007)
It Takes A Village Educational Services
P.O. Box 1116, Cochrane, AB, T4C 1B2 ☺ Phone: (403)932-6501