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In order to ensure the protection of children in the care of Zion Lutheran School, school policy requires prior to any and all persons providing a volunteer service at the school or for any function conducted b 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 application declining to complete a "Volunteer Background Check" acknowledgement form will not be considered.
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Potential Volunteer Information
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Sex:
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History Information
Complete the information below.
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1. Have you ever volunteered at Zion before? *
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2. Have you ever plead guilty or been convicted of a felony in a state or federal court? *
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3. Have you ever plead guilty or been convicted of a misdemeanor in a state or federal court? *
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4. Are you the subject of a current criminal investigation or have pending charges against you? *
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Zion Lutheran School 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 well being of children. Providing false information, or information contradicting the background check information, is grounds for immediate volunteer denial.
By affixing our signature to this form you acknowledge your statements are to be true and give full consent to complete a name based on based background through ICHAT.
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I understand this is a legal representation of my signature.
Clear
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OFFICE USE ONLY:
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