CCPS Fingerprinting Scheduler
The Virginia State Police, Federal Bureau of Investigation (FBI) and the Department of Social Services (DSS) with Culpeper County Public Schools (CCPS) are permitted to obtain a full national criminal history record on individuals who are seeking employment, as well as those wishing to serve in the capacity of a volunteer, chaperone, coach, advisor, student-teacher, or intern. Such background checks are necessary to ensure a safe and secure learning and working environment. Please review the following document prior to completing this form:
https://drive.google.com/file/d/12Yv0A4MYc7w7j8h-dU8ScxEYyirh_jub/view?usp=sharing
Name: *
Phone: *
Email: *
Reason: *
Select Date: *
MM
/
DD
/
YYYY
Time: *
Time
:
Authorizations and Disclosures
By completing this form I affirm that I have not been charged and/or convicted (as guilty or not innocent) of a violation of law other than a minor traffic violation. I affirm that I have NOT been a subject of a founded case of child abuse or neglect. I agree to conform to the school's district rules and regulations and to participate in orientation and training. I agree to respect the confidential nature of student information as well as my personal contact with staff members. In the event that I violate these stipulations, I understand that my employment or volunteer service may be terminated by Culpeper County Public Schools.
By Selecting “I Authorize” in the box below, I empower this school system to be my designated representative for the purpose of obtaining my criminal history as well as the state registry of founded cases of child abuse or neglect. I certify that I have received and read the above paragraphs and agree to follow the points stated. I have made true, correct and complete answers and statements on this application. *
Required
Submit
Never submit passwords through Google Forms.
This form was created inside of Culpeper County Public Schools. Report Abuse