Grandville Schools Volunteer Background Check (non employment) 25-26

Grandville Schools Volunteer Background Check (non employment) 25-26

In order to ensure the protection of children in the care of Grandville Public 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 Background Check” acknowledgement form will not be considered. Volunteers shall be continually supervised by Grandville employees and shall not be unsupervised at any time while volunteering with students unless the volunteer submits results of a background check through the Michigan State Police CHRISS system.

ONLY 1 BACKGROUND CHECK IS NEEDED PER SCHOOLYEAR AND INCLUDES ALL EVENTS, SCHOOL BUILDINGS AND CHILDREN.

This background check if valid for ONE SCHOOL YEAR

Record of this waiver and the background check results will be kept confidential for the life of the report.

Volunteers Legal Name Volunteers Legal Name First Middle Last
Legal name must match Identification
Date of Birth Date of Birth / MM / DD YYYY
Gender

Gender Male Female
Race

Race Asian/Pacific Islander Black American Indian/Alaskan Native White Other
Volunteers Phone Volunteers Phone - ### - ### ####
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Students Name
Email
School Building

School Building Central Century Park Learning Center Cummings East Grand View South West Oakestown Middle School High School ELC (ECSE) Other Other
Name and Date of Event
Have you volunteered at Grandville Public Schools before?

Have you volunteered at Grandville Public Schools before? YES NO
Have you ever pled guilty or been convicted of a felony in a state or federal court?

Have you ever pled guilty or been convicted of a felony in a state or federal court? YES NO
If Yes, please include date of offense, state in which felony occurred and brief explanation
Have you ever pled guilty or been convicted of a misdemeanor in a state or federal court?

Have you ever pled guilty or been convicted of a misdemeanor in a state or federal court? YES NO
If Yes, Please include date of offense, state in which misdemeanor occurred and brief explanation
Are you the subject of a current criminal investigation or have pending charges against you?

Are you the subject of a current criminal investigation or have pending charges against you? YES NO
If Yes, Please include date of offense, state in which it occurred and detailed description of conviction
Upload clear copy of valid drivers license or government issued identification. Background check will not be processed without clear identification
Grandville Public Schools 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 wellbeing of children. Providing false information or information contradicting the background check information is grounds for immediate volunteer denial. Contact Human Resources, 616-254-6589 with questions or concerns.
By affixing your signature to this form you acknowledge your statements are to be true and give full consent to complete a name based background check through ICHAT. You also agree to contact the Grandville Public Schools Human Resources Office of any future criminal investigation or pending charges against you after the date of this form. You also release the Grandville Public Schools of any obligation should you become ill or receive an injury as a result of your volunteer services.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.