NARRAGANSE1T SCHOOL SYSTEM - Narragansett Schools

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KAREN M. HAGAN, CPA SUPERINTENDENT FAX (401) 792-9439 ... As a volunteer at the Narragansett School System, I will abide by the confidentiality agreement, and
NARRAGANSETT SCHOOL SYSTEM ADMINISTRATIVE OFFICES 25 FIFTH AVENUE NARRAGANSETT, RHODE ISLAND 02882-3699 KATHERINE E SIPALA SUPERINTENDENT

Telephone (401) 792-9450 FAX (401) 792-9439

KAREN M. HAGAN, CPA DIRECTOR OF FINANCE

JUDITH PAOLUCCI, Ph.D.

ELIZABETH PINTO

ASSISTANT SUPERINTENDENT

ADMINISTRATOR OF STUDENT SERVICES

(401) 792-9426

Dear Volunteer, Your service as a volunteer is deeply appreciated. Volunteers augment educational opportunities for children, and help teachers provide individually appropriate attention. According to the Narragansett School Committee policy on volunteering in the schools, all volunteers must have a background check. We need your support and help as a volunteer. As a volunteer, you will come to know the strengths and needs of the children you assist. Moreover, since children are disclosing with trusted adults, you may learn about their families and other aspects of their lives. In order to maintain the privacy of children and their families, volunteers must abide by confidentiality. Before beginning service as a volunteer, it is requested that you fill out the attached form and return to your school office or to the school administration office. You do not need a complete FBI background check done but simply a criminal record check. It is also requesting that you acknowledge your intent to fulfill the responsibility by endorsing the statement below. Please be advised that we value your contribution, and hope that you will derive a measure of personal satisfaction from your experience at the Narragansett School System.

As a volunteer at the Narragansett School System, I will abide by the confidentiality agreement, and never discuss my observations and knowledge of the children and their families with others. I understand all information regarding students and staff is strictly confidential whether medical or otherwise, and must never be discussed. If I have questions or concerns, I will immediately inform the child’s classroom teacher.

__________________________________ Signature of volunteer Please print name: _________________________________

____________________ Date

NARRAGANSETT SCHOOL SYSTEM ADMINISTRATIVE OFFICES 25 FIFTH AVENUE NARRAGANSETT, RHODE ISLAND 02882-3699 KATHERINE E SIPALA SUPERINTENDENT

Telephone (401) 792-9450 FAX (401) 792-9439

KAREN M. HAGAN, CPA DIRECTOR OF FINANCE

JUDITH PAOLUCCI, Ph.D.

ELIZABETH PINTO

ASSISTANT SUPERINTENDENT

ADMINISTRATOR OF STUDENT SERVICES

(401) 792-9426

RELEASE OF INFORMATION AUTHORIZATION

I hereby direct and authorize the Narragansett School System to review any criminal records that is on file in reference to me. I hereby waive and release any and all manner of actions, causes of actions, and demands of every kind, nature and description, arising from any release of criminal records and requests there from, whatsoever against the Narragansett School System in both law and equity which I may now have or in the further may have. I am also aware that it is my responsibility to contact the Narragansett School System if any criminal charges are brought against me after this date.

Signed this _____________day of ________________________, 2009.

__________________________________________________________ Full Name __________________________________________________________ Signature

__________________________________________________________ Street City/Town

________________ Drivers License No.

Before me _______________________ Notary Public

________________ Date of Birth

Term Expires on __________________

________________ Social Security No.

Information requested by: Narragansett School System For: Volunteering

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