Plainfield Community School Corporation

Welcome to the approval process.

This registration process includes:

Information Collection
Background Check Authorization

Please click the 'Next Step' button to start the process

Additional Policies

Are you over 18 years of age?*

Yes*

No*

If you're under 18, you need to go back and apply as a Student

Would you agree to a criminal background check?*

Yes*

No*

Background check is required to volunteer in the Hillsborough County Public School system. Thank you.

Personal Auto Liability Policy:

Florida requires that all drivers carry minimum automobile insurance. A volunteer who drives/parks his or her automobile on Hillsborough County Public School (HCPS) property while providing volunteer service must meet this minimum requirement.

Do you plan to drive/park on HCPS property while volunteering?*

Yes*

No*

I have read the above and agree to abide by the Florida requirement to carry minimum automobile insurance*

Yes*

No*

Thank you for your interest in volunteering in the Hillsborough County Public School system. We are unable to accept your application at this time if you are unable to meet the minimum automobile insurance requirement.

Personal Information

I have a SSN*

Yes*

No*

You are required to submit your Social Security Number (SSN) for the purposes of a Criminal Background Screening. Do not answer "No" if you have a government issued SSN. Failure to submit SSN may result in delay of processing or application denial. View Privacy Policy.

If you are a current HCPS employee, enter employee number.*

If you are a current HCPS student, enter student number.*

School*

First Name*

Middle Name*

Last Name*

Maiden/Family Name*

Have you ever used a last name other than the last name/maiden name entered above?*

Yes*

No*

Last Name*

If you're under 18, you need to go back and apply as a Student

Date of Birth indicates that you are over the age of 18. Please go back and select "Volunteer/Community Partner" to complete application. Thank you.

Birthdate*

Gender*

Marital Status*

Are you Hispanic/Latino?*

Ethnicity*

Phone Number (no dashes)*

Alternate Phone*

Email*

Drivers License #/State ID*

Issuer*

Highest Level of Education Completed*

Home Address

Street Address*

Apt or #*

City*

State*

Zip Code*

Have you lived at this address less than 5 years?*

Previous Address

Street Address*

Street Address 2*

City*

State*

Zip Code*

Employer

Employer Name*

Employer Address

Street Address*

Street Address 2*

City*

State*

Zip Code*

How longed have you worked for this employer?*

Occupation*

District Affiliation

Are you related to a student at the school in which you plan to volunteer?*

Yes*

No*

Volunteer Preferences

Volunteer Category* Category Descriptions

Preferred Grades*

Preferred Schools*

Group Affiliation*

Only select if volunteering as member/representative of a group/organization.

Describe the group affiliation*

I have read and agree to adhere to these mentor policies.*

I have read and agree to adhere to these faith-group policies.*

I have read and agree to adhere to these policies.*

Languages*

Special Skills or Hobbies*

My signature

I understand that I am offering my services to the Hillsborough County Public School System without compensation. I certify that all information given on this application is true and complete. Any misrepresentation, omission or incorrect statement of facts called for in this application is cause for immediate dismissal of me as a volunteer. I agree, if I am a volunteer, to abide by all school board rules, regulations and policies, either published or in effect by usage and all rules, regulations and laws of the State of Florida as may be required by Florida Statutes and the School Board of Hillsborough County.

I hereby certify that the information provided on this form is true and correct to the best of my knowledge. By attaching the signature, I agree and understand that the typed electronic signature shall have the same legal effect as an original signature and is being accepted as my original signature.

Applicant Signature*

Florida has a very broad public records law. Most written communications (including email) to or from state officials regarding state business are public records available to the public and media upon request. Your email communications may therefore be subject to public disclosure.

First Name*

Middle Name*

Last Name*

Birthdate*

Verify Birthdate*

Entered DOB's do not match

Verified

Invalid DOB. Age must be between 14 and 120.

Social Security Number*

If you don't have an SSN, please enter "999-99-9999".

Verify Social Security Number*

Entered SSN's do not match

Verified

Street Address*

Apt or #*

City*

State*

Zip Code*

Phone Number (no dashes)*

Email*

Drivers License #/State ID*

Issuer*

In order to complete your background check, please provide any and all Professional Licenses so that we may verify your credentials

License Number	License Type	Issuing Agency	State Issued
{{license.licenseNumber}}	{{license.licenseType}}	{{license.agency}}	{{license.stateIssued}}
Please provide at least one professional license.
If you have applied for a license, but not yet been approved, please use "Pending" as the License Number.

has Licenses*

Additional notes*

Have you ever been convicted, plead guilty or no contest before a court for any federal, state or municipal criminal offense, such as a misdemeanor/felony, regardless of the age of conviction? Please include any felony/misdemeanor driving offenses such as Driving While Suspended, DWI(Driving Under the Influence) or OWI(Operating a Vehicle Under the Influence). Traffic infractions (ie speeding or parking tickets) are not required for disclosure.*

Please provide the details (state, county, date and details of conviction).*

Have you ever received probation or community supervision for any federal, state or municipal criminal offense?*

Please provide the details (state, county, date and details of conviction).*

Have you ever been convicted of any criminal offense in a country outside the jurisdiction of the United States?*

Please provide the details (city, country, date and details of conviction).*

Do you currently have any pending charges against you?*

Please provide the details (state, county, date and details of conviction).*

AUTHORIZATION

I agree to the terms of this agreement*

My signature*

Payment Information

By clicking "Submit", I am authorizing Safe Hiring Solutions to charge my credit card the total amount of {{(vm.registration.cost) | currency}} to order the background check on {{vm.registration.firstname}} {{vm.registration.lastname}}. Additional fees may apply in order to complete the background screening process.

Credit Card - Visa, MasterCard and Discover Only*

CCV*

Expiration Month*

Expiration Year*

REQUEST SUCCESSFULLY SUBMITTED

Plainfield Community School Corporation

Welcome to the approval process.

This registration process includes:

Please click the 'Next Step' button to start the process

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DISCLOSURE REGARDING BACKGROUND INVESTIGATION

Policies & Acknowledgements

Additional Policies

Personal Auto Liability Policy:

Personal Information

Home Address

Previous Address

Employer

Employer Address

District Affiliation

Volunteer Preferences

My signature

ENTER YOUR INFORMATION

AUTHORIZATION

Payment Information

REQUEST SUCCESSFULLY SUBMITTED