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Form: Background Check

* indicates a required answer.

BACKGROUND CHECK AUTHORIZATION FORM

Trinity Homeschool Enrichment requires a background check on all non-student participants and third party instructors age 18 or older to ensure the safety of our children. The following information is required to complete your secure background check.  All information provided remains confidential and is only shared with designated board members. 

1. *

Full LEGAL Name

2.

Maiden Name and/or Alias (list all if applicable)

3. *

State of Issue for Drivers License or ID

4. *

LAST four digits of drivers license or ID Card

5. *

Date of Birth (MM/DD/YYYY)

6.

Gender

 
Male Female
7.

Other states you have lived (after age 17)

8. *

I hereby authorize Trinity Homeschool Enrichment to obtain personal information which includes charges and/or convictions for federal and state criminal law violations. Personal information may also be obtained from public online sources such as social media. I understand this information will be used, in part, to determine my eligibility for a volunteer position with the organization. I understand this authorization remains in effect until my volunteer position ends and background checks may be repeated at any time. If I dispute the record, I may request a copy of the information.  

By typing my name below I certify that this will act as my physical signature and will be binding as such for all purposes. 

Type Name of parent and/or legal guardian

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