School Participation - Mentor Program or Volunteer Application 2023-2024

1. Applicant Information

The purpose of this application is to become an approved volunteer or mentor at Advantage Academy. Approval is based on the results of a criminal background check performed using the information you provide below. You must complete all pages for your application to be processed.

If you are applying to become a mentor, you must speak with the mentor organization, Heart & Home Ministries, before submitting this application. For contact information, please visit www.advantageacademy.org/our-students/heart-and-home-ministries
If you are applying to become a volunteer and would like assistance or more information, please give us a call at 214-276-5839

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* 1. Name (as written on ID)

First Name

Last Name

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* 2. Date of Birth

MM/DD/YYYY

Date

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* 3. Driver's License or Government Issued ID #

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* 4. What state issued this ID?

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* 5. Current Contact Info

Main email

Main phone #

Address

City

State

Zip

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* 6. Other names used (if applicable):

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* 7. Have you ever been charged, plead guilty, or convicted of a felony?

Yes

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* 8. If yes, please describe

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* 9. Which option best describes your purpose for submitting this application?

I am applying to become a Mentor through Heart & Home Ministries (Partnering Pals).

I am applying to volunteer, assist, or serve on campus or school sanctioned outings.

I am applying to become an Advantage Academy Club Sponsor or Host.

I am applying to become a Student Teacher at Advantage Academy.

Other (please specify in box below)

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* 10. Campus(es)

Dallas (PK-8)

Waxahachie (PK-8)

Grand Prairie West (PK-8)

Grand Prairie East (9-12)

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* 11. Preferred Days (Check all that apply)

Mon

Tues

Wed

Thur

Fri

Sat

Other (please specify)

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* 12. Preferred times

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* 13. Spouse Name (If Spouse is an Advantage Academy Employee)

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* 14. Do you have a child/grandchild/family member/foster child currently attending AA?

Yes

If yes, please list (1) student's name, (2) student's grade, and (3) your relationship with the student.

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* 15. Are you able and willing to chaperone student field trips?

Yes

Not applicable to my application

If yes, what grade(s) do you plan to chaperone? List field trip date, field trip location and teacher name (if known)

STATEMENT OF ACCEPTANCE AND AUTHORIZATION

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* 16. I have carefully read and understand this application and authorization. By selecting YES below, I certify the information I provided on this application is true and correct to the best of my knowledge. I understand that any information found to be intentionally withheld or fraudulent, will result in a denial of my application. I agree that this application and authorization in original, faxed, photocopied or electronic form will be valid for any reports that may be requested by or on behalf of Advantage Academy. I understand that the criminal history information obtained by Advantage Academy and its representatives will not be released or disclosed to any person(s) and that such record(s) will be considered CONFIDENTIAL. I also understand that I may withhold my permission and that in such a case, no investigation will be done, and my application will not be processed further.

YES, I certify the information I provided is true and correct to the best of my knowledge.

NO, I cannot certify the information I provided is true and correct to the best of my knowledge. I understand that my application will not be processed further.

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* 17. Signature (type full name)

Activities and duties shall be at the discretion and direction of Campus Administration with proper notification. Advantage Academy reserves the right to decline the activities, participation, or services of anyone for any reason without cause or notice.

By clicking the SUBMIT button below, I hereby consent and authorize Advantage Academy, its designated agents, and representatives to conduct a comprehensive review of my background and for an investigative report to be obtained for the purposes of evaluating whether I qualify for the school volunteer role for which I am applying. I understand that the scope of the review may include, but is not limited to the following areas: verification of social security number; current and previous residences; civil and criminal history records from any criminal justice agency in any or all federal, state, or county jurisdictions.

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* 18. In order to receive approval, please attach a photo copy of your drivers license or government issued ID.

PDF, DOC, DOCX, PNG, JPG, JPEG file types only.

Choose File

NOTE: In order for this application to be processed, you must click next to go to the next page. The next page is a TX DPS CCH Verification form which authorizes Advantage Academy to perform a criminal history background check. The next form is required by state law and is required to process your application. If not completed you will be required to submit a new application again.