Please complete this application form if you are interested in becoming a Math Achievement Partnership (MAP) volunteer tutor for the Appleton Area School District (AASD). Once you complete the form, click the continue button at the bottom.


Name and address


Availability

Please indicate the days and time of day you are usually available to volunteer.



School Preference(s)

Indicate school(s) you are interested in tutoring at in order of preference. (Huntley, Columbus, Johnston, Richmond, Houdini, Highlands) Indicate 'any' if no preference.



Previous Volunteer Experience

Please list any previous volunteer experience.



Personal Interest

How did you learn about this volunteer opportunity to tutor with the Math Achievement Partnership (MAP) program?



Emergency Contact


Personal Reference


Business Represented

Please indicate the business you represent as an Appleton School District volunteer (as appropriate).



Demographic Information

Your date of birth and gender are used to help us get a better idea of the demographic make-up of our volunteers.



Previous Residency

List all cities and states in which y ou have resided since your 18th birthday and indicate the number of years of residency there. This information will be used for background check.



Agreement Section

The Math Achievement Partnership (MAP) program is committed to the responsibility of providing a safe and positive experience for the students we serve. This program practices a strict standard in volunteer screening. Should any of the required background and reference checks reveal concerns that potentially put a child in a position of risk, the tutor applicant will be denied. It is the policy of this program to always err on the side of safety when deciding to place a tutor with a child. If denied, the applicant will be notified in writing of this decision and the circumstances.


It is a matter of policy and procedure that criminal background checks and police record checks are done on every tutor candidate. Background checks are then repeated every five years for as long as you continue tutoring. AASD has contracted with the Background Investigative Bureau (BIB) to conduct high quality background checks on potential volunteers using their Secure Volunteer technology. You will receive information about initiating the background check process in a separate message.


All personal information provided will not be used for discriminatory purposes relating to your application. I hereby authorize the release and exchange of information between Math Achievement Partnership and the any necessary law enforcement agency, Background Investigative Bureau (BIB), or county Department of Social Services.


This authorization may be revoked by me at any time and will expire in six months unless an alternate date is specified. I am aware some of this information will be disclosed from records whose confidentiality may be protected by federal law.


Federal regulations prohibit Math Achievement Partnership from making any further disclosure of this information without specific written consent of the person to whom it pertains, or as otherwise permitted by such regulations.

I certify that the information I have provided in this application is true and factual. I understand that falsification of this application constitutes grounds for rejection or termination from this tutoring program.