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WOM Volunteer Profile 2023-24
This form collects information that allows WOM to run a background check on you. We require background checks for all in-school volunteers and drivers every two years. Feel free to fill out the paper version of this form if you have any concerns about submitting your information on a Google form. We keep all of this information private.
We will also require a signed copy of the
official background check authorization form
.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Last Name
*
Your answer
First Name
Your answer
Middle Name (if none, indicate N/A)
*
Your answer
Street Address
*
Your answer
City & State
*
Your answer
Zip Code
*
Your answer
County of residence
*
(ie, Chatham, Wake, Orange, Durham, Alamance, etc)
Your answer
Phone Number
*
Your answer
Alternate phone number
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Social Security Number
*
If you would rather, you can call us at 919-240-7787 and give it to us over the phone. Just indicate that below. We cannot run the check until we have this information.
Your answer
Name as it appears on your Social Security Card
*
Your answer
Typing your full name below indicates that the above is true and complete to the best of your knowledge.
*
Your answer
If you are interested in DRIVING for a school field trip, sports practice, etc, there is an additional safe driver background check that will be conducted.
Would you like to be approved to DRIVE?
*
Yes
No
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