Limited Criminal History Consent (Level 2)
United Schools of Indianapolis (USI) schools are accountable for the safety and security of students during the school day. We take this responsibility very seriously. As part of our Charter Agreement, all USI school volunteers, employees and employees of contractors or subcontractors who have direct ongoing contact with USI students within the scope of their employment or through ongoing volunteerism in the building are subject to national, state and local criminal background checks to the fullest extent permitted under applicable law. USI reserves the right to make a determination whether a criminal history record is satisfactory or not.

I authorize United Schools of Indianapolis to obtain a limited criminal history report on my behalf, understanding that if United Schools of Indianapolis determines my criminal history record is unsatisfactory, I will not be permitted to have direct, ongoing contact with United Schools of Indianapolis students.
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Email *
Your legal name (First, Middle, Last) *
Date of Birth *
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Gender *
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Social Security number *
Race *
Current Address (Street, Apt #, City, Zip) *
Phone number *
What school is this Background Check for? *
Reason for Background Check *
Required
Student Name (First Last) *
Required for Field Trip Chaperone. For Volunteer enter N/A.
Student's Teacher Name and Grade *
Required for Field Trip Chaperone. For Volunteer enter N/A.
Destination and date of field trip *
Required for Field Trip Chaperone. For Volunteer enter N/A.
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