Background Check

indicates a required answer

A background check is required of all instructors at Crown Homeschool Community. Please fill out the form for your background check submission.

1. *

Do you voluntarily consent to this background check?

(1 required)

Yes

2. *	Name on Driver's License:

3. *	Driver’s License #:

4. *	State Issued:

5. *	Name on Social Security Card:

6. *	Social Security #:

7. *

Have you ever been convicted of any felony?

(1 required)

Yes

8. *

Have you ever been convicted of any misdemeanor?

(1 required)

Yes

9. *

Do you currently have any felony or misedemeanor charges pending against you?

(1 required)

Yes

10.	If yes (to any of these), please explain:

11. *	Date of Birth ( mm / dd / yyyy ):

12. *	Current Address:

13. *	Phone Number:

14. *	Email Address:

15. *	By typing your full name and today's date in this box, you are indicating your consent to a criminal background check.