Background Check
Serving children under the age of 18 at Bethel Valparaiso requires a background check. Please submit this form to complete your background check.
First Name:
Your answer
Middle Name:
Your answer
Last Name:
Your answer
Home Address:
Your answer
Phone Number:
Your answer
Date of Birth
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Gender:
Race:
I promise to report any signs of emotion, verbal, or physical abuse that I suspect to a Bethel Valparaiso Staff Member.
I promise that I will remain confidential when working with children. Not using names when telling stories or testimonies, without parent permission.
I promise to only post pictures on social media after checking with Chelsey to confirm that parent permission has been given.
I promise that all information on this form is to my best of knowledge correct.
I give Bethel Valparaiso Staff permission to complete an Indiana Criminal Background Check for the name on the top of this form. Please type your name.
Your answer
Please select the date.
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This form was created inside of Bethel Valparaiso - All Nations Church. Report Abuse - Terms of Service - Additional Terms