Volunteer Background Check Renewal Authorization
I authorize Trinity Lutheran School to run a renewal background check with Protect My Ministry. I understand that my previously submitted information will be used.
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Email *
Student Name(s) *
Full Name *
Street Address, City State & Zip *
Social Security Number *
Date of Birth *
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PLEASE SUBMIT a current copy of your AUTO INSURANCE CARD to office@trinitylcs.org or drop off in the school office.
THERE IS AN $10 RENEWAL FEE. Your youngest K-8 student's account will be billed. Please submit payment to the school office.
I hereby authorize Trinity Lutheran Church and School and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report to be generated for volunteer purposes. I understand that the scope of the consumer report/investigative consumer report may include, but is not limited to the following areas: verification of social security number, credit reports, current and previous residences, employment history, education background, character references, drug testing, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions, driving records, birth records, and any other public records. I further authorize any individual, company, firm, corporation, or public agency (including the Social Security Administration, Department of Motor Vehicles, and law enforcement agencies) to divulge any and all information, verbal or written, pertaining to me, to Trinity Lutheran Church and School or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company firm, corporation, or public agency may have, to include information or data received from other services. I certify that all the information in this Volunteer Application is truthful and accurate. I agree to notify the school within 14 days of any changes in any of the above information. I agree to abide by the safety procedures established by Trinity Lutheran Church and School. Trinity Lutheran Church and School and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicant's personal information, including, but not limited to, addresses, social security numbers, and dates of birth. The owner of the vehicle must carry bodily injury insurance. The school’s insurance does not cover damages arising from, or related to, the operation of any private vehicle, failure to follow the directed driving route, or any personal negligence related to the field trip. I understand that all students in the School are given instruction in the Christian religion according to the doctrine, discipline, and worship of the Lutheran Church Missouri Synod (LCMS) and I will respect those beliefs when volunteering with students. *
SIGNATURE *
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