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BCS Volunteer Screening Form
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* Indicates required question
Email
*
Your email
Date
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MM
/
DD
/
YYYY
Name (Last, First, MI)
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Social Security Number
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(Info will be used for background check only and then discarded.)
Your answer
Cell Phone Number
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Your answer
Home Address (Street, City, State, Zip Code)
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Your answer
I authorize Bible Center School/Church to conduct a background check on me.
*
Yes
No
Have you ever been convicted of, pled guilty to, a crime other than a traffic violation?
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Yes
No
If you answered yes to the question above, please explain.
Your answer
Have you ever acted in a "sexually inappropriate" manner with a minor? (By "sexually inappropriate" we mean any physical contact, verbal communication, or visual interaction whereby a minor was used for sexual stimulation.)
*
Yes
No
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