CSB Volunteer Application Form
Thank you for your interest in being a volunteer at the California School for the Blind (CSB)!

Volunteer activities at our school may include, but are not limited to:
  • Assisting classroom teachers in activities with students;
  • Directly assisting students with assignments and activities, and might include working in art, music, Braille, adapted physical education activities, and dorm events;
  • Working with teaching, dormitory, library and other staff members in preparing materials for students for academics and recreational purposes; and
  • A variety of activities to assist students in their academic, social and personal growth.

As a State Special School, we require all volunteers to complete the following:

  • Completed volunteer application (this form)
  • A live scan of your fingerprints (fees vary depending on where you get it done; this is reimbursable by our school)
  • TB risk assessment (fees may apply depending on your health insurance)

The live scan may be completed at a local UPS Store or police station. The Live Scan Request form will be sent to you from our Human Resources department via email. This takes about a week to process so please consider that timeframe and complete this process before volunteering on-campus.

The minimum age to volunteer is 16 years old, however if you are under 18, that will include obtaining permission from your parent or guardian.

You will then receive training on general principles of working with people who are visually impaired, and receive your assignment. We ask that you commit to the hours you will serve (minimum of 1 full school quarter), and treat those hours as you would your job - that is, you are here regularly as scheduled, let us know when you are ill, and notify us if you are tracking your volunteer hours as community service.
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Full Legal Name *
Address
Home Phone Number
Cell Phone Number
E-mail Address *
Are you 16 years of age or older? (Volunteers must be 16 years old to volunteer with the state of California) *
Current Employer *
Occupation *
Educational Background *
Do you have CPR or First Aid Certification? *
Languages Spoken
Do you have any physical limitations?
Clear selection
If you selected "Yes" above, please list any physical limitations you may have.
What prompted you to seek volunteer work? *
Do you have any particular interests, talents, hobbies or skills? *
What do you hope to gain from volunteering here? *
Please list all volunteer experience.
Please list any experience you have with people with visual impairments.
Personal References
Please list three personal references we may contact. (Name, Phone number, and Relationship)
Personal Reference #1: 
(Name, Phone number, and Relationship)
 *
Personal Reference #2: 
(Name, Phone number, and Relationship)
 *
Personal Reference #3: 
(Name, Phone number, and Relationship)
 *
Availability
Please answer a few questions about your availability.
What hours and days are you available to volunteer? *
Monday
Tuesday
Wednesday
Thursday
Friday
AM (9:00AM - 12:00PM)
PM (12:30 - 3:30 PM)
How much time do you anticipate being available to volunteer?
How did you hear about our volunteer program?
Would you be interested in any of the following areas to volunteer in? *
Required
Optional: Are you a certified Life Guard?
Clear selection
Certification of Application
Answers will not necessarily disqualify you from consideration.
Have you ever been convicted by any court of an offense? 
The following need not be reported:
■ Minor traffic violations for which the fine was $50 or less.
■ Any offenses which were finally settled in a juvenile court or under a welfare youth offender law.
■ Any incident that has been sealed under welfare and institutions code section 782 or penal code
section 1203.45.
■ Any conviction specified in health and safety code section 11261.5. This section pertains to
various marijuana offenses.
 *
Has your driver's license ever been suspended or revoked? *
If you answered "Yes" to any of the questions above, please list all offenses providing the date, location, nature, and disposition for each.
Do you possess a valid California driver's license? *
If you answered "Yes", please enter your driver's license number.
The State Superintendent of Public Instruction is an elected official. Is there anything in your past or presently that could potentially cause embarrassment to the California Department of Education and/or the State Superintendent of Public Instruction?
 *
If you answered "Yes", please explain.
Questions/Comments for us?
Please read below and enter your initials as a signature. *
I certify under penalty of perjury that the information I have entered on this application is true and complete to the best of my knowledge. I further understand that any false, incomplete, or incorrect statements may result in my disqualification from becoming a volunteer at the California School for the Blind. I authorize the employers and educational institutions identifies on this application to release any information they may have concerning my employment or education to the State of California.
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