Volunteers - WNES (Limited Criminal Background Check)
All potential volunteers MUST complete this form in order to have a limited criminal background check done. Volunteer status is dependent upon this background check.
Last Name *
Your answer
First Name *
Your answer
Birthdate *
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DD
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Phone Number *
Your answer
Student's Name *
Your answer
Homeroom Teacher *
Your answer
Have you ever been investigated for, charged with, or pleaded guilty or "no contest" to any crime involving the sexual abuse of any person or indecency with a minor? *
Have you ever been charged with a crime, other than a minor traffic offense? *
If you answered "yes" to either of the above questions, please explain.
Your answer
Electronic Signature (please type your first and last name) *
I authorized the School Town of Highland to check my employment and background history, including without limitation, reference checks, and to seek the release of investigatory information, including a "limited criminal history", possessed by any private or public employer or local, state, or federal agencies to provide the School Town of Highland any information they may release concerning the matters described therein, and I will cooperate to the extent necessary to obtain the release of this information. I expressly waive in connection with any request for, or provision of such information, any claims or causes of action, including without limitation, defamation, infliction of emotional distress, invasion of privacy, or interference with contractual relations that I might otherwise have against the school corporation, its officials, employees, trustees or agents, or against any provider of such information. I HAVE READ THIS AUTHORIZATION AND RELEASE AND I EXPRESSLY AGREE TO THE TERMS SET OUT HEREIN.
Your answer
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