Joy E. Sharp. Dear Potential Ohio 4-H Volunteer,

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1 Ohi State University Extensin Pickaway Cunty Cllege f Fd, Agricultural, and Envirnmental Sciences 110 Island Rad, Suite B PO Bx 9 Circleville, Ohi Dear Ptential Ohi 4-H Vlunteer, Phne Fax Thank yu fr expressing an interest in becming an Ohi 4-H vlunteer. Each year, thusands f adult and teen vlunteers cntribute time, energies, and talents that help enable Ohi 4-H t fulfill its missin f helping yuth t becme caring, capable, and cntributing citizens. Ohi State University Extensin has specific plicies and prcedures fr vlunteer selectin. All individuals wh are interested in vlunteering with Ohi State University Extensin and wrking with a member f a vulnerable ppulatin (minr, elderly ver age 65, r individuals with disabilities) must adhere t OSU Extensin selectin prcedures. T mre efficiently and effectively supprt ur Ohi 4-H members, parents, vlunteers, and prfessinals, Ohi State University Extensin has a plicy cncerning the selectin f individuals wh desire t vlunteer fr the rganizatin. While the actual rder f implementatin may vary frm cunty t cunty, all ptential vlunteers will: (1) receive a psitin descriptin; (2) cmplete an applicatin and return it t the Extensin ffice; (3) have references cllected by Extensin prfessinals; (4) submit t a criminal histry fingerprint recrd check; (5) cmplete an interview; (6) agree t and sign the vlunteer standards f behavir frm; and (7) participate in a 4-H vlunteer Orientatin Prgram. Please knw that this infrmatin may be updated peridically and will be kept in a secured file. This infrmatin will be kept n file fr a minimum f ne year fllwing the receipt f yur applicatin r the terminatin f yur invlvement as an Ohi 4-H vlunteer (whichever is lngest). The release f infrmatin will fllw The Ohi State University and Ohi State University Extensin peratin prcedures and will be in accrdance with Ohi law. Wrking with individuals in yur cmmunity can bring yu immense satisfactin as yu help them grw, learn, develp, and succeed. Additinally, vlunteering prvides yu an pprtunity t gain new skills, help thers, and meet new peple and develp imprtant relatinships. We hpe that yu recgnize the tremendus benefits f vlunteering and will jin us in helping ensure that everyne invlved has a psitive, educatinal experience. We appreciate yu cperatin and lk frward t ptentially wrking with yu. Sincerely, Jy E. Sharp Jy E. Sharp Extensin Educatr 4-H Yuth Develpment

2 OHIO STATE UNIVERSTIY EXTENSION PROCEDURE FOR VOLUNTEER SCREENING FOR ALL POTENTIAL 4-H VOLUNTEERS IN PICKAWAY COUNTY The fllwing steps need t be taken by all ptential 4-H Vlunteers prir t acting in the capacity f a 4-H Vlunteer Leader in Pickaway Cunty: 1. Pick up the Ptential 4-H Vlunteer packet at OSU Extensin, Pickaway Cunty, secnd flr, Pickaway Service Center, 110 Island Rad, Circleville, Ohi. Our ffice hurs are Mnday, 8:00am 7:00pm, and Tuesday-Friday, 8:00am 4:30pm. Or dwnlad the packet frm ur OSU Extensin, Pickaway Cunty website ( The Packet includes: 1) General 4-H Vlunteer Psitin Descriptin; 2) Vlunteer Applicatin Frm; 3) Standards f Behavir. 2. Cmplete the applicatin, sign the standards f behavir and submit bth frms t the Extensin ffice. Our ffice will send letters t the listed references. Applicants will want t fllw up with references, reminding them that it is imprtant t return the reference frm t the Extensin Office as sn as pssible, as the applicatin is nt cmplete until all reference frms are received. 3. The Applicant must submit t a mandatry criminal backgrund check. Applicants will need t make an appintment t have fingerprints taken and be prepared t pay the $30 cash fee at the time f fingerprinting. If an applicant has received a criminal backgrund check within the last twelve mnths f applying, this backgrund check can be submitted and will be accepted by OSU Extensin. After the backgrund check results are received by OSU Extensin, an interview will be scheduled. 4. The interview will be cnducted as an infrmal discussin f vlunteer experiences, strengths the candidate can bring t the prgram, and views n wrking with adults and children. If the interview is successful, the fllwing will take place: The applicant will receive a letter frm OSU Extensin indicating ne f the fllwing: 1) the applicant has been accepted pending participatin in a 4-H Vlunteer Orientatin meeting within ne year; 2) the applicant has nt been accepted; r 3) Mre infrmatin is needed prir t making a decisin. 5. Acceptance as a 4-H vlunteer des nt autmatically give the individual the right t becme an advisr in the club f ne s wn chsing. If an applicant is interested in becming an advisr in an already established club, the ptential vlunteer must gain permissin t be an advisr in a specific club frm the club s rganizatinal advisr. 6. If an applicant is interested in establishing a new 4-H club, upn acceptance as a 4-H vlunteer, OSU Extensin can prvide the apprpriate infrmatin n starting a new 4-H club in Pickaway Cunty. CFAES prvides research and related educatinal prgrams t clientele n a nndiscriminatry basis. Fr mre infrmatin: g.su.edu/cfaesdiversity.

3 Vlunteer Psitin Descriptin 4-H Yuth Develpment Ohi State University Extensin Psitin Title: 4-H Club Vlunteer Organizatinal, Prject r Activity Time Required: On-ging and dependent n cunty General Purpse: Supprt and wrk in partnership with 4-H prfessinals, vlunteers and members in cnducting meaningful educatinal experiences t help yuth grw and reach their fullest ptential. Specific Respnsibilities: Prvide a variety f 4-H prject related learning experiences, including: Crdinate and cnduct educatinal activities related t prject areas. Mnitr prgress twards prject cmpletin. Prepare members fr judging, skillathn, and exhibitin Infrming members f prject requirements, deadlines, and events & activities. Prvide cnstructive feedback t members, parents, and families. Advise members in crdinating/cnducting club activities, including: Cmmunity service, fund raising, club trips & turs, recreatinal activities, achievement prgrams, prmtinal activities, parent s night and thers. Prmte 4-H pprtunities in yur club and lcal cmmunity, including: Encurage 4-H members and parents interest and participatin. Invite parents ideas, cperatin, supprt and attendance at 4-H activities. Recruit new members when the club has penings. Infrm members f cunty 4-H events & activities. Actively participate as a vlunteer by: Fllw OSU Extensin and 4-H Yuth Develpment guidelines and plicies. Attending all (r mst) f the club meetings and activities. Read 4-H mailings and access infrmatin frm the 4-H web t keep members, parents and/r ther vlunteers infrmed. Participate in vlunteer develpment pprtunities. Qualificatins & Expectatins: Ability, interest, and willingness t: Wrk with vlunteers and 4-H prfessinals t teach and mtivate yuth while nurturing psitive self esteem, decisin making, respnsibility, and leadership. Effectively rganize, delegate, and cmmunicate (verbal and written) Wrk with minimal supervisin frm prfessinal staff. Becme familiar with and wrk within the philsphy and guidelines f Ohi State University Extensin, Ohi 4-H Prgram and the Cunty 4-H prgram. Ohi State University Extensin Agrees t: Prvide training pprtunities t assist vlunteers t meet needs f members and parents. Prvide access t educatinal materials and resurces. Have prfessinal staff available t cnsult with and listen t vlunteers. Prvide apprpriate recgnitin and awards t vlunteers. Mentr/Supervising Prfessinals: Cunty Extensin 4-H Yuth Develpment Prfessinal(s)

4 INTEREST CHECK LIST FOR OHIO 4-H VOLUNTEER WHAT I LIKE TO DO A LOT A LITTLE NOT AT ALL Speaking T Grups Organizing Prgrams/Events Leading a Discussin Grup Keeping Recrds/Ding Paperwrk Typing Camping Cntacting Peple Teaching Adults Teaching Yuth (ages 5-8) Teaching Yuth (ages 9-12) Teaching Yuth (ages 13-20) Drawing r Sketching Presiding At Meetings/Events Serving n Cmmittees Writing News Articles Appearing On Radi/TV Meeting New Peple Junir Fair Wrk Fund Raising Develping Displays

5 OHIO STATE UNIVERSITY EXTENSION I. GENERAL INFORMATION Ohi 4-H Vlunteer Applicatin Full Name: Date f Birth (MM/DD/YY): Street Address: City/State/Zip: Length f time at this address (years): Phne: Hme: Best Time t Call: Cell: Schl District: Wrk: Best Time t Call: Best Time t Call: Are Yu a 4-H Alumni: Yes N If yes, what state and cunty: Demgraphic Infrmatin Occupatin (ptinal): Level f Educatin (ptinal): Ethnicity: Hispanic Nn-hispancic Race: White Black American Indian/Alaskan Native Hawaiian/Pacific Islander Asian Residence: Farm Twn/Rural (<10,000) Twn (10,000-50,000) Suburb (< 50,000) City (> 50,000) Military Service: N ne in my family is currently serving My Parent serves My Sibling serves My Sn/Daughter serves I/my spuse/partner serve Branch f Service: Air Frce Army Cast Guard Marines Navy Branch Cmpnent: Active Guard Reserves Health Cnsideratins/Ntes (i.e., fd allergy, diabetes, etc ): II. VOLUNTEER INTEREST Why are yu interested in vlunteering fr the Ohi State University Extensin 4-H Prgram? hi4h.rg CFAES prvides research and related educatinal prgrams t clientele n a nndiscriminatry basis. Fr mre infrmatin: g.su.edu/cfaesdiversity.

6 D yu prefer t wrk directly with yuth r adults? Yuth Adults Bth If yu prefer t wrk directly with yuth, what age level(s) d yu prefer? Ages 5-8 Ages 9-12 Ages N Preference Type f 4-H Vlunteer Psitin: 4-H Club: Organizatinal Leader Clverbud Leader Prject Leader Resurce Leader Prject Area Interests: Cmmittee Member list cmmittee: Camp (check all that apply): Residential Day Special Interest/Emphasis Prgram list prgram: After-Schl Prgram list site: Cmmunity Center/Yuth Organizatinal Partner list site: Other: If yu are applying t vlunteer with a cmmunity/prject club, will yu be requesting t start a new club r assisting with an existing club? New Exisiting If exisiting, name f club: What time cmmitment d yu initially desire t give? Previus Wrk Experience (list current r mst recent experience first): Emplyer Psitin Title Year Previus Vlunteer Experience (list current r mst recent experience first): Emplyer Psitin Title Year Ohi 4-H Vlunteer Applicatin, 2/15 Page 2

7 III. PERSONAL REFERENCES Have yu ever been cnvicted f a misdemeanr r a felny? Yes N If yes, please give date, nature, and dispsitin f ffense: Please nte: A criminal recrd will be cnsidered as it relates t specifics f the vlunteer psitin fr which yu are applying. A criminal recrd may prevent an individual frm vlunteering, depending n the nature f the ffense. References: List nn-family members wh have knwledge f yur skills, abilities, and qualificatins. Individuals shuld have wrked with yu n prjects and activities and/r have direct experience with r knwledge f yur qualificatins. Please prvide cmplete addresses, phne numbers and addresses. Name: Street Address: Relatinship: City/State/Zip: Phne: Name: Street Address: Relatinship: City/State/Zip: Phne: Name: Street Address: Relatinship: City/State/Zip: Phne: I authrize the cntact f listed references and understand that I am required t submit t a fingerprint criminal backgrund check prir t final cnsideratin f my applicatin t vlunteer. I understand that misrepresentatin r missin f required infrmatin is just cause fr nn-appintment as a vlunteer with Ohi State University Extensin. I understand that I serve at the pleasure f Ohi State University Extensin and agree t abide by the plicies f Ohi State University Extensin and the Ohi 4-H Prgram and t fulfill the vlunteer respnsibilities t the best f my ability. Permissin t use phtgraphic frm fr prmtin cntingent upn cmpleting vlunteer prcess: Ohi State University Extensin wuld like t share the psitive results f yuth and vlunteer participatin in Extensin and 4-H Yuth Develpment events. Hwever, in sme cases, vlunteers may prefer nt t permit such publicity. I GIVE I DO NOT GIVE the Ohi State University permissin t publish in print, electrnic, r vide frmats the likeness r image f myself. I release all claims against the University with respect t cpyright wnership and publicatin including any claim fr cmpensatin related t use f the materials. (If nt cmpleted, OSU Extensin will nt use publicity abut yur participatin). Applicant Signature: Date: Ohi 4-H Vlunteer Applicatin, 2/15 Page 3

8 OHIO STATE UNIVERSITY EXTENSION VOLUNTEER STANDARDS OF BEHAVIOR These Standards f Behavir are accepted by vlunteers wh cmmit t an Ohi State University Extensin ( OSUE r Extensin ) prgram as a cnditin f their vlunteer status. The Standards f Behavir shall guide vlunteer s behavir during their invlvement in Extensin prgrams. Just as it is a privilege fr Ohi State University t wrk with individuals wh vlunteer their time and energies t the rganizatin, a vlunteer s invlvement with OSUE is a privilege and a respnsibility, nt a right. OSUE prvides quality educatinal prgrams accessible t all Ohi citizens. The primary purpse f this Standard f Behavir is t ensure the safety and well-being f all Extensin prgram participants (i.e., members, their parents and families, prfessinals, and vlunteers). Vlunteers are expected t functin within the guidelines f OSUE and the individual prgram area (4-H, Agricultural & Natural Resurces, Family & Cnsumer Sciences, and Cmmunity Develpment). Extensin vlunteers shall act with persnal integrity. Ohi State University Extensin vlunteers will: Uphld vlunteerism as an effective way t meet the needs f yuth and adults. Uphld each individual s right t dignity, self-develpment, and self-directin. Accept supervisin and supprt frm prfessinal Extensin staff while invlved in the prgram. Accept the respnsibility t represent their individual cunty Extensin prgram and The Ohi State University. Cnduct themselves in a curteus and respectful manner, exhibit gd sprtsmanship, and prvide psitive rle mdels fr all yuth. Respect, adhere t, and enfrce the rules, plicies, and guidelines established by their individual cunty Extensin prgram and OSUE. Nt engage in abusive behavirs that physically r verbally threaten r harm any Extensin prgram participant, including yuth. Nt engage in any act prhibited by law. Cmply with all civil rights laws and plicies, including but nt limited t OSUE equal pprtunity, anti- discriminatin laws, and prgram participant plicy. Perfrm duties in a respnsible and timely manner as utlined in the psitin descriptin. Immediately reprt any threats t the vlunteer s emtinal r physical well-being t the cunty Extensin prfessinal. Accept the respnsibility t prmte and supprt Extensin prgrams in rder t develp an effective cunty, state, and natinal prgram. Handle animals and perate machinery, vehicles, and ther equipment in a respnsible manner. I understand and agree that as a vlunteer: In accrdance with Ohi State University plicy, Self-Disclsure f Criminal Cnvictins Plicy 4.17, I am required t selfdisclse criminal cnvictins within three business days f the cnvictin. I will uphld and supprt the respnsible and lawful use f scial media. In s ding, I will nt create r pst scial media cntent that is abusive, threatening, defamatry, bscene, harassing, r creates a hstile envirnment. I will reprt any child abuse, sexual abuse, r neglect in accrdance with university plicy I will nt intentinally r purpsefully place myself in a psitin alne with a member f a vulnerable ppulatin in a nen-ne situatin, including, but nt limited t sleeping quarters with participants. I will nt, under any circumstances, physically, verbally, r emtinally abuse r fail t prvide the basic necessities f care, such as fd r shelter t participants. I will endeavr t prvide a safe and healthy prgram/camp experience fr all participants. My vlunteer status is subject t immediate suspensin r terminatin based n any act r missin that Extensin determines t be cntrary t any prtin f these standards r therwise in cnflict with the gals f OSUE. I have read, understand, and agree t be bund by the VOLUNTEER STANDARDS OF BEHAVIOR utlined abve. Vlunteer Signature Date CFAES prvides research and related educatinal prgrams t clients n a nndiscriminatry basis. Fr mre infrmatin: { }Ver.10/ TGrdy

9 OHIO STATE UNIVERSITY EXTENSION OSU EXTENSION VOLUNTEER CRIMINAL HISTORY RECORD CHECKS All ptential Ohi State University vlunteers (including all ptential 4-H vlunteers) will submit t and successfully pass a criminal histry fingerprint backgrund check befre being apprved t vlunteer with 4-H and every fur years thereafter. In Pickaway Cunty, we recmmend that yu have yur fingerprints taken at the Pickaway Cunty Educatinal Service Center (PCESC), 2050 Stneridge Rad, Circleville, OH (ff f Tarltn Rad). Cntact Lydia Rittinger at the PCESC ffice at t schedule a fingerprinting appintment. The fee is $30.00 cash r mney rder at the time f fingerprinting (they d nt accept checks). Please take this letter with yu when yu g t have yur fingerprints taken. What yu ll need t have fr yur Fingerprint Backgrund Check 1. A gvernment issued pht ID such as yur driver s license with yur current address, and shwing yur date f birth. 2. Yur Scial Security number knw yur number, yu dn t need t bring yur SS card. 3. Per the Ohi Attrney General s ffice, use as the reasn cde yu are having the fingerprint backgrund check. 4. If yu have nt lived in Ohi fr the past 5 years, yu must als have a FBI reprt run. 5. Backgrund check results must be mailed t: Attentin: Gina Thrpe PICKAWAY COUNTY OSU Office f Human Resurces 1590 N. High St., Suite. 300 Clumbus, OH Acceptable frm f payment 7. Yu can request a cpy f the results be sent t yu PREVIOUS CHECKS COMPLETED If yu have cmpleted an Ohi BCI fingerprint backgrund check within the past twelve mnths fr a reasn related t wrking with children, wrking with the elderly, r certain types f licensure, yu can ask BCI t send a cpy f that reprt directly t the OSU Extensin Vlunteer Backgrund Crdinatr. The BCI request frm can be fund at Please fllw the instructins n the frm and send the request directly t BCI. On the request frm, indicate the cpy reprt shuld be mailed t: OSU Extensin Vlunteer Backgrund Crdinatr, 2201 Fred Taylr Drive, Clumbus, OH Please nte: if yu are nt sure if yu can request a cpy f a past reprt, cntact the BCI Civilian Identificatin Department at /24/2015 PICKAWAY COUNTY CFAES prvides research and related educatinal prgrams t clientele n a nndiscriminatry basis. Fr mre infrmatin: g.su.edu/cfaesdiversity.