The Ohio State University Extension
Mahoning County
490 South Broad St.
Canfield, Ohio 44406-1604
Phone: 330.533.5538
Fax: 330.533.2424
Dear Potential Mahoning County 4-H Volunteer,
Thank you for your interest in volunteering with the 4-H program in Mahoning County.
According to the Ohio State University Extension Volunteer Policy effective November 1, 2002, all
potential volunteers will: (1) receive a position description; (2) complete an application and return it
to the Extension Office; (3) have references collected by Extension professionals; (4) complete an
interview; (5) submit to a criminal history fingerprint record check; and (6) agree to and sign the
volunteer standards of behavior form.
Attached you will find all the information you will need to complete each phase of the volunteer
selection process.
Please review the attached 4-H volunteer position description and retain it for your
personal 4-H records.
Complete the 3-page volunteer application and standards of behavior form in their
entirety and return both forms to the Mahoning County Extension Office, 490 South
Broad Street, Canfield, OH 44406.
Contact the Extension Office to schedule your face-to-face interview with the 4-H
Educator.
Have your fingerprints taken electronically at one of the locations on the attached list.
Ink cards are no longer accepted; fingerprints must be obtained electronically.
Information about processing your background check is included in this packet.
The volunteer selection process takes approximately 3 to 4 weeks to complete and must be
completed successfully before a volunteer begins to work with the Mahoning County 4-H program.
Therefore, please plan accordingly and return the enclosed application at your earliest convenience
so that we may begin the process. To be an approved volunteer for 2010 the volunteer selection
process must be completed by April 30, 2010.
If you have any questions, please feel free to call at 330-533-5538.
Sincerely,
Janice Hanna, Extension Educator
4-H Youth Development
OHIO STATE UNIVERSITY EXTENSION
VOLUNTEER APPLICATION FORM
(To be completed by all potential Volunteers)
I. GENERAL INFORMATION
Name:_______________________________________________________________________
(First) (Middle) (Last)
Mailing
Address:____________________________________________________________________
(Street) (City) (Zip)
Length of time at this address (years): ____________ _______________________
Date of Birth (MM/DD/YY)
Phone: Day: ( ) ________________________ Best Time to Call: ________________
Eve: ( ) ________________________ Best Time to Call: ________________
Email ______________________________________________________________________
II. VOLUNTEER INTEREST
Why are you interested in volunteering for O.S.U. Extension?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
With which OSU Extension program area do you want to volunteer:
______ Agricultural & Natural Resources ______ Community Development
______ 4-H Youth Development ______ Master Gardners
______ Family & Consumer Sciences ______ Other
Do you prefer to work directly with youth or adults: ____ Youth ____ Adults ____ Both
If you prefer to work directly with youth, what age level(s) do you prefer?
Ages 5-8 ______ Ages 9-12 ______ Ages 13-19 ______ No Preference ______
What time commitment do you initially desire?
1-2 months per year ____ 3-6 months per year ____ 6-12 months per year ____ Ongoing ____
Previous Work Experience: (List current or most recent experience first)
Employer Position Title Year
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Previous Volunteer Experience: (List current or most recent experience first)
Organization Volunteer Role Year
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
III. PERSONAL REFERENCES
Have you ever been convicted of a misdemeanor or a felony? Yes _____ No _____
If yes, please give date, nature, and disposition of offense.
__________________________________________________________________________________
Please note: A criminal record will be considered as it relates to specifics of the volunteer position for which you are
applying. A criminal record may prevent an individual from volunteering, depending on the nature of the offense .
References: List three (3) non-family members who have knowledge of your skills, abilities, and
qualifications. Individuals should have worked with you on projects and activities and/or have direct
experience with or knowledge of your qualifications. Please provide complete addresses and phone numbers.
Name: _________________________ _______________ _______________ ______________
Relationship Home Phone Work Phone
Address:__________________________________________________________________________________
(Street) (City) (State) (Zip)
Name: _________________________ _______________ _______________ ______________
Relationship Home Phone Work Phone
Address:__________________________________________________________________________________
(Street) (City) (State) (Zip)
Name: _________________________ _______________ _______________ ______________
Relationship Home Phone Work Phone
Address:__________________________________________________________________________________
(Street) (City) (State) (Zip)
I authorize the contact of listed references and understand that I am required to submit to a fingerprint criminal background check
prior to final consideration of my application to volunteer. I understand that misrepresentation or omission of required information is
just cause for non-appointment as a volunteer with Ohio State University Extension. I understand that I serve at the pleasure of the
Ohio State University Extension and agree to abide by the policies of Ohio State University Extension and individual program areas and
to fulfill the volunteer responsibilities to the best of my ability.
Applicant Signature: __________________________________________________________ Date: _________________________
Please return the application at your earliest convenience and contact us if you have any questions or wish
further information. Thank you!
OHIO STATE UNIVERSITY EXTENSION
VOLUNTEER APPLICATION FORM
(Mahoning County 4-H Interest)
Are you a 4-H alumnus? Yes ________ No ________
Where were you in 4-H? ______________________________________
(County/State)
Have you ever been a 4-H volunteer? Yes ________ No ________
If yes, how many years? _________
Where? __________________________________________________________________
(City) (County) (State)
In what capacity would you like to work with the 4-H program? (check all that apply)
______ Community / Project Club Advisor ______ School Club / Group Volunteer
______ Community / Project Club Volunteer ______ Special Emphasis Group Volunteer
______ Committee Member ______ Other: _______________________
Would you be helping with an existing club ____ or establishing a new club ____? (check one)
Name of 4-H Club: ________________________________________________________
Name of 4-H Club Head Advisor: ____________________________________________
Please return the application to: Ohio State University Extension
Mahoning County
490 South Broad Street
Canfield OH 44406
OHIO STATE UNIVERSITY EXTENSION
VOLUNTEER STANDARDS OF BEHAVIOR
This Standards of Behavior is a contractual agreement accepted by volunteers who
commit to an Ohio State University Extension program. The Standards of Behavior shall guide
volunteers’ behavior during their involvement in Extension programs. Just as it is a privilege for Ohio
State University Extension to work with individuals who volunteer their time and energies to the
organization, a volunteer’s involvement with Ohio State University Extension is a privilege and a
responsibility, not a right.
Ohio State University Extension provides quality educational programs accessible to all
Ohio citizens. The primary purpose of these Standards of Behavior is to insure the safety and well
being of all Extension program participants (i.e., members, their parents and families, professionals,
and volunteers). Volunteers are expected to function within the guidelines of Ohio State University
Extension and the individual (4-H, Agriculture, Natural Resources, Family & Consumer Sciences,
Community Development) program area. Ohio State University Extension volunteers shall be
individuals of personal integrity.
Ohio State University Extension volunteers will:
Uphold volunteerism as an effective way to meet the needs of youth and adults.
Uphold an individual’s right to dignity, self-development, and self-direction.
Accept supervision and support from professional Extension staff while involved in the program.
Accept the responsibility to represent their individual county Extension program and the Ohio State
University Extension program with dignity and pride by being positive mentors for the youth with
whom they work.
Conduct themselves in a courteous and respectful manner, exhibit good sportsmanship and provide
positive role models for all youth.
Respect, adhere to, and enforce the rules, policies, and guidelines established by their individual
county Extension program and Ohio State University Extension.
Not engage in abusive behaviors that physically or verbally threaten or harm any Extension
program participant, including youth.
Not commit a felonious act.
Comply with all civil rights laws and policies, including but not limited to O.S.U. Extension equal
opportunity, anti-discrimination laws, and program participant protection policy.
Perform duties in a responsible and timely manner as outlined in the job description.
Report immediately any threats to the volunteer’s emotional or physical well being to the county
Extension professional.
Accept the responsibility to promote and support Extension programs in order to develop an
effective county, state, and national program.
Handle animals and operate machinery, vehicles, and other equipment in a responsible manner.
CONTINUE ►►►►
OHIO STATE UNIVERSITY EXTENSION
Member/Service Recipient Protection
Volunteers will not intentionally or purposefully place themselves in a position alone with
a member of a vulnerable population, in a one-on-one situation, including, but not limited
to, sharing sleeping quarters with non-related members and/or participants.
Volunteers will endeavor to provide safe and healthy programs for all participants. In
cases of illness or injury, participants will be treated on-site by the appropriate health
care provider or taken to an appropriate health care provider if necessary, when a legal
parent, guardian or caregiver is not available for consultation.
Volunteers will not, under any circumstances, physically, verbally or emotionally abuse or
fail to provide the basic necessities of care, such as food or shelter, to members or
participants.
I have read and understand the Standards of Behavior and Member/Service recipient protection
policy outlined above. I understand and agree that any act or omission on my part that contradicts
any portion of these standards is grounds for immediate suspension and/or termination of my
volunteer status with the Ohio State University Extension program.
________________________________________ _____________________________________________
Signature of Applicant Date Signature of Extension Professional Date
Ohio State University Extension
Volunteer Selection
Evaluating Criminal Offenses
Statement on Criminal Offenses
Revised Ohio Senate Bill 187 identifies offenses that are to be considered disqualifying
for those who desire to work with minors. Ohio State University Extension considers
those offenses, and those that are substantially equivalent, as automatically
disqualifying when considering an individuals qualifications for working with members of
a vulnerable population (minors, elderly over age 65, and individuals with disabilities).
There are likely to be additional criminal offenses, not identified on this list that will
surface when conducting criminal fingerprint background checks on potential volunteers.
Offenses identified that are not listed as disqualifying offenses must be thoroughly
evaluated prior to making a decision concerning a potential volunteers acceptance into
the organization.
Considering Criminal Offenses
As decisions are made concerning individuals who have criminal records, the following information is
critical and must be thoroughly evaluated and discussed prior to making any decision. It will be
necessary to discuss the facts with the county chair, district specialist, district director, and/or
identified representative from your state program area or Extension administration. Extension
professionals will consider the following:
Nature of offense identified
Time the offense occurred (year) or age when offense occurred
Parties affected by the offense (minors, elderly, disabled)
Potential volunteer responsibilities (i.e. relationship to vulnerable populations)
Relationship of offense to potential responsibilities
Opportunity to place individual in alternative role (no responsibilities for vulnerable
populations)
2903.01 Aggravated murder; specific intent to cause death
2903.02 Murder
2903.03 Voluntary manslaughter
2903.04 Involuntary manslaughter
2903.05 Felonious assault
2903.06 Aggravated assault
2903.07 Failing to provide for functionally impaired person
2903.08 Aggravated menacing
2903.09 Patient abuse, neglect
2905.01 Kidnapping
2905.02 Abduction
2905.03 Child stealing
2905.04 Child enticement
2907.02 Rape
2907.03 Sexual battery
2907.04 Corruption of a minor
2907.05 Gross sexual imposition
2907.06 Sexual imposition
2907.07 Impositioning (now importuning)
2907.08 Voyeurism
2907.09 Public indecency
2907.12 Felonious sexual penetration
2907.21 Compelling prostitution
2907.22 Promoting prostitution (children)
2907.23 Procuring
2907.25 Prostitution: after positive HIV test
2907.31 Disseminating matter harmful to juveniles
2907.32 Pandering obscenity
2907.321 Pandering obscenity involving a minor
2907.322 Pandering sexually oriented matter involving a minor
2907.323 Illegal use of a minor in nudity oriented material or performance
2911.01 Aggravated robbery
2911.02 Robbery
2911.11 Aggravated burglary
2911.12 Burglary
2919.12 Unlawful abortion
2919.22 Endangering children
2919.23 Interference with custody
2919.24 Contributing to the unruliness or delinquency of a child
2919.25 Domestic violence
2923.12 Carrying concealed weapons
2923.13 Having a weapon while under a disability
2923.161 Improperly discharging a weapon at or near a school or dwelling
2925.02 Corrupting another with drugs
2925.03 Trafficking in drugs
2925.04 Illegal manufacture of drugs or cultivation of marijuana
2925.05 Funding of drug or marijuana trafficking
2925.06 Illegal administration or distribution of anabolic steroids
2925.11 Possession of drugs (that is not a minor drug possession offense)
3716.11 Placing harmful objects in food or confection
And any “substantially equivalent offense”
Ohio State University Extension
Volunteer Selection Policy & Procedures
Frequently Asked Questions
Why has the OSU Extension Volunteer Selection Policy and Procedures changed?
Over the past several years, many changes have taken place in relation to volunteers working with youth, elderly, and
individuals with disabilities. Among these changes are increased expectations of parents, guardians, and caregivers that
the organization provide a safe and positive environment for their children; a new state law providing guidelines for
volunteer selection policy and procedures; and a desire to provide an emotionally and physically safe environment within
the organization.
Who is affected by the new Volunteer Selection Policy and Procedures?
All new, potential volunteers recruited by O.S.U. Extension faculty and staff, who will be working with members of a
vulnerable population, are required to adhere to the new policy and complete each procedure as outlined in the policy.
What happens if a potential volunteer refuses to complete any part of the required policy or procedures?
Individuals must fully complete all requirements in order to be considered for acceptance as a volunteer for Ohio State
University Extension.
Who determines if an applicant is going to be accepted or not accepted as a volunteer?
The appropriate Ohio State University faculty or staff member will make the final decision of acceptance or non-
acceptance, based on information collected throughout the selection process.
What will happen to reports that are received from the Bureau of Criminal Investigation?
All reports will be sent to a central location at Ohio State University Extension, Columbus campus. Results of individual
reports will be communicated to the appropriate Extension professional responsible for the processing of that individual’s
application materials. Actual reports will not be sent to county Extension offices.
What happens if there is a conviction on my record?
Current legislation outlines fifty (50) offenses that are considered automatic disqualifying offenses. Offenses beyond the
fifty listed will be evaluated individually and decisions will be based on the nature of the offense, time since the offense,
rehabilitative action taken and/or completed by the individual, and relationship to potential volunteer responsibilities.
Will I have to submit to a criminal history fingerprint background check every year?
At this time, the policy only requires that fingerprint background checks be conducted when an individual initially applies
to be a volunteer.
I volunteer/work for another organization and was required to submit to a fingerprint background check last month; do I
need to do another one?
Ohio State University Extension will accept the results of a criminal history fingerprint background check that was
conducted by the Bureau of Criminal Identification & Investigation providing it was done within the previous twelve (12)
months. Additionally, the individual will be responsible for securing proof of the check and/or paying for all costs
associated with securing proof of the fingerprint check.
MAHONING COUNTY 4-H VOLUNTEER
BACKGROUND/INTERVIEW SELECTION PROCEDURES
WHEN SHOULD I SCHEDULE MY FACE-TO-FACE INTERVIEW?
It is the responsibility of the volunteer applicant to contact the Mahoning County Extension
Office at 330-533-5538 to schedule an interview. The office is open Monday through Friday
from 8:00am- 4:30pm to call. Interviews can be scheduled for any time.
WHERE CAN I GET MY FINGERPRINTS TAKEN?
Because Ohio State University Extension submits more than 200 requests for background
checks through BCI&I, starting February 1, 2006, all background checks must be
submitted electronically. This can either be done through WebCheck or other approved
methods.
We understand that there will be times when an ink-rolled fingerprint card will need to be
submitted. These situations will be evaluated on an individual basis and will require
submission of a waiver form with each card. Waivers will be granted for the following
reasons:
1. Applicant’s home address is 75 miles or more from the nearest WebCheck location.
2. Amputations or missing digits
3. Out-of-state applicant
4. Poor quality prints (not able to capture at the WebCheck location)
Please refer to the list on the back of this page for agencies that provide electronic
fingerprinting.
Pay close attention to fees, hours of operation, and contact persons, as these vary among
agencies. Most require appointments.
Individuals who have previously had a criminal history record check conducted (in the last 12
months) may use that record check to meet Ohio State University Extension requirements. You
will need to provide the County Extension Office with a copy of your background check results.
WHO PAYS FOR THE FINGERPRINTING AND BACKGROUND CHECK?
Potential volunteers are required to pay all fees associated with the selection process.
WHERE DO I SEND MY FINGERPRINT RESULTS?
All fingerprint reports should be sent to:
State 4-H Office
2201 Fred Taylor Dr.
Columbus, OH 43210
Contact agency ahead of time to determine
method of payment.
Burdman Group, Inc. Tri-State Investigations
284 Broadway Street 5234 Southern Blvd., Suite B
Youngstown, OH 44504 Boardman, OH 44512
330.743.9275 330.788.9945
Mon. - Fri. 8:00 a.m. - 4:00 p.m. Mon. - Thurs. 9:00 a.m. - 3:00 p.m.
Fee: $25.00 Fri. 9:00 a.m. - 11:00 a.m.
Fee: $30.00
Bureau of Motor Vehicles (NWC) Contact Terri
242 Federal Plaza West (Call Extension Office for directions.)
Youngstown, OH 44503
Walk-in only between Youngstown State University Police (NWC)
Mon. - Fri. 8:00 a.m. - 4:30 p.m. (Mahoning County)
1 University Plaza
Mahoning County Educational Service Center Youngstown, OH 44555
100 DeBartolo Place, Suite 105 330.941.1986
Youngstown, OH 44512 Mon. - Thurs. 9:00 a.m. - 6:00 p.m.
330.965.7828 BY APPOINTMENT ONLY
By Appointment Only Fee: $30.00
Contact Jane Renkenberger
Fee: $27.00 Master Security, Inc.
(Call Extension Office for directions.) 1745 Belmont Ave. Yo, OH 44504
330-746-4448
National Background Check, Inc. (NWC) mastersecurityinc.com
19 East Front Street $32 BCI (state)
Youngstown, OH 44503 $35 FBI
877.932.2435 $60 both
Mon. – Fri. 8:30 a.m. – 5:00 p.m. by appointment
Fee: $35
The Ohio State University, The United States Department of Agriculture, and Mahoning County Commissioners Cooperating