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ADULT (18+) Volunteer Background Check Authorization Form
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Applicant Info
Name
Email
Voluntary Disclosure Statement: Have you ever been convicted of, or pled guilty or nolo contendere to any crime (other than minor traffic violation)?
Please explain. Note that conviction of a crime will not necessarily disqualify an applicant – the nature of the crime, how it relates to the position, and when the conviction occurred will be considered.
No
Yes
DOB
SSN
Driver's License
