2025-26 Bloomfield Hills Schools Volunteer Background Check Acknowledgment Form
In order to ensure the protection of children in the care of Bloomfield Hills Schools, school policy requires, prior to any and all persons providing a volunteer service at the school or for any function conducted by the school; all potential volunteers complete a State of Michigan background check.  The background check is a name check only, through the State of Michigan ICHAT system and is based on individual identifiers.  Any applicant declining to complete a "Volunteer Background Check" acknowledgment form will not be considered.

Bloomfield Hills Schools reserves the right to "approve" or "deny" any volunteer service upon review of the background check returned through ICHAT.  The determination will be based upon the individual's fitness to have responsibility for the safety and wellbeing of children.  Providing false information, or information contradicting the background check information, is grounds for immediate volunteer denial.

This form only needs to be completed once per school year, per person.  You do not need to complete one for each child in the district.

The building administration will be made aware of approvals/denials.

PLEASE DO NOT USE NICKNAMES
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Email *
School Location (please select all that apply): *
Required
Service to Provide (i.e. Volunteer, chaperone, etc.): *
Date to provide service: *
Please list all BHS students this form applies to.  
If this does not apply to you, please enter N/A.
 *
First Name: *
Last Name: *
Middle Initial:
Maiden name, and/or any other names used.  If none, please enter N/A: *
Date of Birth (Please do not use today's date): *
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Gender: *
Ethnicity: *
Have you volunteered at Bloomfield Hills Schools in the past? *
Have you ever pled guilty, or been convicted of a felony in a state or federal court? *
If you answered "yes" to the above question, provide a detailed description of the state offense/conviction and date occurred.  If you answered "no" to the above, please type N/A: *
Have you ever pled guilty, or been convicted of a misdemeanor in a state or federal court? *
If you answered "yes" to the above question, provide a detailed description of the state offense/conviction and date occurred.  If you answered "no" to the above, please type N/A:
 *
Are you the subject of a current criminal investigation or have pending charges against you? *
If you answered "yes" to the above question, provide a detailed description of the state offense/conviction and date occurred.  If you answered "no" to the above, please type N/A:
 *
By typing your name below, you acknowledge your statements to be true and give full consent to complete a name based background check through ICHAT.

Sign below:
 *
Date Signed: *
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