Volunteer Application


IMPORTANT: If you'd like to volunteer as a Site Coordinator, please follow application instructions here: http://getsmartoregon.org/volunteer.html


Please fill out the application below. Red indicates required fields.
If you do not have an email address, please complete a PAPER APPLICATION.
Are you a MINOR under 18 years of age?
Date:
Legal First Name:
Middle Name:
Legal Last Name:
Preferred First Name:
Mailing Address:
City:
State:
County:
Zip:
Home Phone: ( ) -   Example: (503) 123-4567
Mobile: ( ) -   Example: (503) 123-4567
Email:
Company/ Organization:
Office Phone: ( ) -   Example: (503) 123-4567
In which county would you like to volunteer?  Click here to find a school near you.

NOTE: SMART is currently not available in Columbia, Gilliam, Harney, Lincoln, Malheur and Sherman Counties. To learn how you can help bring SMART to you community, click here.

I would like to be placed where the need for volunteers is greatest.
I would like to volunteer near my address (above).

I would like to choose my top three (3) school preferences.
Please list, in order of preference, the SMART school(s) where you would like to volunteer?
First Preference
Second Preference
Third Preference
NOTE: Volunteers are scheduled on a first come, first served basis. We will accommodate your preferences whenever possible.

For scheduling assistance, questions or concerns, please contact your your local SMART representative.
Preferred day(s): Monday Tuesday Wednesday Thursday Friday
Preferred time(s): Early Morning (8-10am) Mid-morning (10-Noon) Afternoon (Noon-3pm)
  NOTE: Certain days and times may not be available at every school or in every county.
Do you read in another language? yes no — If yes, please specify  
How did you hear about SMART?
  • SMART volunteer
    Employer
    College/high school
    Media (TV, newspaper, radio)
    Service club presentation
    Friend/Family
    I was a SMART student. School  Years
    Other
Do you know someone interested in volunteering with SMART?
  • Name
    Phone ( ) -  Example: (503) 123-4567
    Email

Volunteer Criminal History Check

Applicants:
• Any felony conviction will prohibit your participation as a SMART volunteer. No exceptions will be made.
• Applications will not be processed until all sections are complete.
• The Oregon Children’s Foundation dba SMART and/or the elementary school has the right to refuse participation by an individual    without demonstrating cause.
List any other names you have used:   *If none, specify by typing N/A in the box
Date of birth:  Example: 05/12/2005
Gender: male female
Driver's License #   *If none, specify by typing N/A in the box
State Issued
Have you been arrested for a crime that has yet to be resolved?
yes no If yes, please specify:
State
County
Year
Offense
Have you EVER been convicted of a crime except a minor traffic violation?
  • yes no
Have you EVER been convicted of a crime involving drugs or alcoholic beverages?
yes no If yes, please specify:
State
County
Year
Offense
Have you EVER been convicted of a crime involving violence, abuse, or threat of violence
yes no If yes, please specify:
State
County
Year
Offense
Have you EVER been convicted of a sex-related crime?
yes no If yes, please specify:
State
County
Year
Offense
Have you been convicted of any other type of crime:
yes no If yes, please specify:
State
County
Year
Offense
Have you EVER been asked to leave any employment or volunteer activity that involved contact with children/minors?
yes no

SMART Volunteer Guidelines
As a SMART volunteer, I will not take children outside or away from the school.
As a SMART volunteer, I will read in view of other adults.
As a SMART volunteer, I will sign in with the school and the SMART coordinator and wear a SMART badge.

Authorization and Release
I have read and understand and commit to following the SMART safety requirements. I declare that my answers and all statements made by me herein are true and correct. All volunteers must sign the authorization below before the application can be processed. Your cooperation is greatly appreciated.

I hereby authorize Oregon Children’s Foundation, dba SMART, the school district and the Oregon Department of Education to conduct a criminal background check on me and to communicate the results of the criminal background check to SMART. I understand that the background check may be conducted by any one or more methods, including without limitation, using government and private databases and services. I understand that a criminal background check may be undertaken at any time, and may be repeated from time-to-time, while I am associated with SMART. I hereby release and hold harmless the Oregon Children’s Foundation dba SMART, the school district, the Oregon Department of Education, and each entity’s employees and agents from any and all liability whatsoever arising from or relating in any way to: any person or entity conducting the criminal background check; the disclosure of information resulting from the criminal background check; and any action which may be taken by any individual or entity based upon that information. I understand that any misdemeanor will be reported to the school principal for volunteer authorization.

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I have read and agree to the guidelines, authorization and release.