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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)
*
In order to volunteer as a mentor/tutor, our school partners require background checks. Do you consent to a Nationwide Criminal Background Check?
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Yes
No
Legal Last Name?
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Legal First Name?
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Gender?
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Female
Male
Other
Date of Birth (month/day/year)?
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Social Security Number? xxx-xx-xxxx
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Phone Number? xxx-xxx-xxxx
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Email Address?
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Current Address?
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City?
State?
Zip Code?
I have lived at this address since? Month/Year
*
School(s) where you would like to volunteer? (Check all that apply. If you do not see your school, select Other)
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Arlington
Deveaux
Escuela SMART
Garfield
Greenwood
Longfellow
McKinley
Old Orchard Mon-Thurs
Sherman
Whittier
Other
Availability-Day of Week? Most sessions are in the morning between the start of school and lunchtime (9a-11:30a)
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Select All
Monday
Tuesday
Wednesday
Thursday
Friday
Are you volunteering as part of a school, university, organization, company or community of faith 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.)?