Titusville Area School District

301 East Spruce Street, Titusville, PA 16354 (814) 827-2715

School Volunteer Information

If you are interested in volunteering in the Titusville Area School District, you must be at least eighteen (18) years of age and complete the following:
Volunteer Application - signed by Building Principal or Athletic Director (annually)
Clearances/Certifications - These clearance/certification forms are available online and are good for five (5) years):

Act 34 Request for Criminal Record Check – Volunteer Only (within one year old)

https://epatch.state.pa.us/TandCVolunteerAction.do

Act 151 PA Child Abuse History Certification (within one year old)

https://www.compass.state.pa.us/cwis/public/home

Act 24/82 Arrest/Conviction Report & Certification (dated same as Disclosure Form)

http://www.education.pa.gov
Act 114 Federal Criminal History Background Check (within one year old); or a School Volunteer Disclosure Affidavit qualifying under Act 153 Child Protective Services Law https://www.pa.cogentid.com
Athletics – Also requires the following trainings and certifications:

Mandated Reporter Training: http://www.gorockets.org/mandatedreportertraining.aspx

NFHS Concussion Certification: http://nfhslearn.com/courses/61037/concussion-in-sports

NFHS Sudden Cardiac Arrest Certification: http://nfhslearn.com/courses/61032/sudden-cardiac-arrest

Tuberculin (TB) test (only for volunteers in contact with students for 10 hours per week or more)
Once you have completed all applicable forms, clearance certifications and health tests, submit your information to the Building Principal or Athletic Director where you will be volunteering.

Please allow at least 2-3 weeks for these clearances to be processed.

These clearances and certifications are in effect for the entire state with the amendment of Act
153 Child Protective Services.
Please note that there is a distinction between visitors and volunteers, as described below. After reading the following descriptions, if you have a question about attendance at or for a specific activity, please contact the Building Principal or Athletic Director at the building you will be volunteering.

VISITOR - A person who is under the direct supervision/oversight of a staff member employed by the District at all times or who does not have direct contact with students.

VOLUNTEER - A person serving in an unpaid capacity where direct supervision by a District staff member may not be provided at all times and the person has direct contact with students.

Volunteer Requirements – 7/14/16

Titusville Area School District

VOLUNTEER Application

In accordance with Policy 916 School Volunteers, all volunteers must have a Volunteer Application on file in the building (Athletic office) where services are provided. Please complete the following information and return the form to the Building Principal or Athletic Director in which you are volunteering to get approval.

Last Name: _First Name: _ MI: _ Phone Numbers: _ _

Address:

City: State:

Zip: County: _

Description of what you will be doing in the building/athletics:_ _

_



_

Name of employee with whom you will be working: _

As a school volunteer, you may become aware of information about a student and his/her family, which is confidential. This can include grades, performance, skills levels and other information shared. It is vital that this information remains strictly confidential.

I agree that confidentiality of student information is critical and shall protect such information.

Volunteer Signature: _

Date_

I have received a copy of the Titusville Area School District Policy 916 School Volunteers; and I

understand the procedures and responsibilities as a volunteer, and I agree to abide by them.

Volunteer Signature: _

Date_

Principal or Athletic Director’s Signature:

Date _

Once you complete the information return the form to the

Building Principal or Athletic Director for approval.

Volunteer Requirements – 7/14/16