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Background Check Consent Form

* indicates a required answer.

Because our volunteers and independent contractors work closely with children, Eastside Homeschool PTSA conducts background checks as a matter of policy. Background checks will be run with the WA State Patrol and with the National Sex Offender Registry. 
 
Results of these checks will be kept confidential. 

1. *

Legal Name:

2. *

Previous Name(s): (please separate each name with a comma)

3. *

Date of Birth (MM/DD/YYYY):

4.*

By Checking This Box You Are Providing Your Signature and Consent To Run Your Background Check:

 (1 required)
I Consent To My Background Check