Parent Leader Application

Parent Leader Application

Parent Info

















Child Information












Additional Information
Please provide the following information to enhance our effectiveness in using your parent leadership skills.









Areas of Knowledge

Adaptive/Assistive
Medical
Mental/Behavioral Health

Parenting

Prematurity
School

Sexuality
State Services
Transitions

Volunteer Agreement

Confidentiality: Under Federal Confidentiality Laws, employees and volunteers of this organization may not disclose information about families, other volunteers or employees to anyone outside this organization without the person’s prior consent and may not disclose this information to persons within this organization except on a “need to know” basis. This includes any identifying information concerning current, past or prospective families, volunteers or employees.

Code of Ethics: Volunteers with Raising Special Kids must be sensitive to the issues of families who have a child with a disability or special health need; appreciate and be sensitive to cultural differences; and be non-judgmental. The volunteer will follow the principles of Raising Special Kids and will not approach the referral family, committees, professionals, as a source for self-promotion (i.e., solicitation, or engaging in business); promoting religious pursuits, or anything that could be considered intrusive to the family or activity that you have agreed to participate in.

Background Check: 
I understand that I will need to complete a DCS Central Registry background check. This is a background check regarding crimes against children. I understand that any information that comes from the background check will not be given to Raising Special Kids except to notify if the background check passed or not, and that anyone who does not pass the background check will be mailed a letter from DCS.

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