Caring For Kids Application
This application must be completed by all persons wanting to serve with minors or vulnerable adults.
Last Name *
Last Name
Your answer
First Name *
legal first name
Your answer
Middle Name *
full middle name
Your answer
Any and all aliases
Include maiden name (if applicable)
Your answer
Gender *
Date of Birth *
mm/dd/yyyy
Your answer
Race
Not required but helpful in completing background check
Social Security Number
Required for background check of those 18 years of age or older
Your answer
Street Address *
Your answer
City/State/Zip Code *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Email Address *
verify email address
Your answer
Best time to contact *
Driver's License #
Leave blank only if you do not have a Driver's License
Your answer
Issuing State for Driver's License
Leave blank only if you do not have a Driver's License
Your answer
Have you ever been charged with, found guilty or pleaded guilty or no contest to a crime other than minor traffic violations? *
Answering "Yes" does not automatically disqualify you from serving.
Have you ever been accused, investigated, charged, arrested or convicted of child abuse, sexual abuse or sexual assault? *
Answering "Yes" does not automatically disqualify you from serving.
Is there anything in your life now or from your past that may affect your ability to report observed, suspected or disclosed abuse situations? *
Would you have difficulty reporting a situation because of something you have experienced?
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