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Afterschool Alliance of NW Ohio
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Mentors in Toledo Schools Background Check Form
Today's Date? (xx/xx/xxxx)
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Do you consent to a Nationwide Criminal Background Check?
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Yes
No
Last Name?
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Legal First Name?
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Gender?
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Female
Male
Other
Date of Birth (m/d/y)?
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Social Security Number? xxx-xx-xxxx
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Phone Number?
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Email Address?
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Address?
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City?
State?
Zip Code?
I have lived at this address since? Month/Year
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School(s) where you would like to volunteer?
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Deveaux Mon-Thurs
Garfield-Mon-Thurs
Larchmont Mon-Thurs
Longfellow Mon-Thurs
Marshall Mon-Weds
McKinley Mon-Thurs
Old Orchard Mon-Thurs
Queen of Apostles Wed. & Thurs
Sherman Mon-Thurs
Whittier Mon. Wed. & Fri
Availability-Day of Week? Shifts available 9a through 11:30a.
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Select All
Monday
Tuesday
Wednesday
Thursday
Friday
Are you volunteering as part of an organization, company or faith-based partner?
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Yes
No
If you answered yes, which organization or faith-based partner are you a part of (example: The Andersons, CedarCreek Church, Area Office on Aging, etc.)?