Background Check Consent Form
The State of Michigan requires all volunteers/staff to have a background check prior to their service at Michiana Christian Camp.
Email address *
Background check consent
In consideration of Michiana Christian Camp's review of my personal record form, I hereby voluntarily consent to and authorize Michiana Christian Camp bearing this release or copy thereof, to obtain a background check. I agree that this background check may include any or all of the following:
Criminal Records
Civil Cases
Motor Vehicle Records
Military Service Verification
Credentials Verification
Education Verification
Personal Identity Verification
Past Employment Verification
Reference Checks
Personal Employment Report
First Name
Your answer
Last Name
Your answer
Middle Initial
Your answer
Current Address
Your answer
Date moved into current address
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/
DD
/
YYYY
Date of Birth
MM
/
DD
/
YYYY
Driver's License Number
Your answer
State Driver's License Issued
Your answer
I certify that the information contained in this document is true to the best of my knowledge.
Signature or Signature of Parent/Guardian if under 18 years of age
Your answer
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