Volunteer/Chaperone Background Check Acknowledgment Form

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Volunteer/Chaperone Background Check Acknowledgment Form

*Non-Employment Background Check Only*

In order to ensure the protection of children in the care of Northwest Community 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/Chaperone Background Check Acknowledgment Form" will not be considered. Forms are valid for the current school year only and should be submitted at least two weeks before the event.

Email *

Potential Volunteer/Chaperone Information

First Name: *

Middle Name: *

Last Name: *

Date of Birth: *

Maiden Name or Other Name(s) Previously Used:

Are you a current employee of... *

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