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IJOC - E - RSU 21 Volunteers

  • Section I: Instruction

IJOC - E - RSU 21 Volunteers


Name______________________________________________ Date of Birth________________________






Home Phone__________________________________ Business Phone___________________________


Driver’s License Number and State_____________________________________


Email Address


Confidentiality and Ethics Statement

As a volunteer for RSU 21, I understand that I have an obligation to maintain the highest level of ethical conduct.  I agree to preserve the confidentiality of any or all information regarding RSU 21 students, staff, and any other related party, and will refrain from engaging in activities that would prejudice my ability (or the ability of others) to carry out my volunteer duties ethically, including violation of criminal or civil laws.


Signature_______________________________________________ Today’s Date____________________


Criminal History

1. Have you ever been charged or investigated for sexual abuse or harassment?


No ___

2. Have you ever been convicted of a crime or pleaded “no contest” to a crime (other than a minor traffic offense)?


No ___

If you have answered “Yes” to either of the above questions, please explain on a separate sheet.  Prior criminal history is not an automatic bar to volunteer service.  All information will be treated confidentially.

I attest that the above statements are accurate and true to the best of my knowledge.  By my signature, I authorize RSU 21 to check criminal and/or civil records.  


Signature_______________________________________________Today’s Date_____________________


  • Please check schools you are willing to volunteer for:

____Kennebunk Elementary School

____Sea Road School

____Mildred L. Day School

____Kennebunkport Consolidated School

____Middle School of the Kennebunks

____Kennebunk High School


____Other   ___________________________________________


It is your responsibility to notify us when you are no longer available.


Amended: 1/9/12

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