• Northwest Allen County Schools

    Limited Criminal Background Check

    Northwest Allen County Schools requires a limited Criminal History Background Check as well as a copy of a driver’s license for all volunteers working in our school in any capacity at any time during the school year.  If you will be working in a classroom, volunteering on a field trip or working with students in anyway, you are required to complete this form and return it to school with your child.

    Please print and use your full LEGAL name.

    Last Name: __________________________________ First Name:_______________________________________ Middle:_______________________________________

    Date of Birth: _______________________                          Gender: _______             Race: ________

    Student’s Name(s): ____________________________________________________________________________

    Grade(s) and Teacher(s): _______________ ________________________________________________________   

    Your relationship to student:______________________________

    Are you currently a Northwest Allen County School employee?   Yes      No

    If yes, what building do you work in?_____________________________

    Are you currently a Northwest Allen County School substitute?  Yes    No

    If yes, what position?       Teacher          Aide/Secretary          Custodian/Matron  

                                              Food Service          Nurse          Bus Driver               Other_______________________

    Today’s Date:  ________________ Signature: ___________________________________________

    Please submit this form along with a copy of your driver’s license to your child’s school.

    Note:  Background checks will only be run between August 1-20, and then again at the start of 2nd semester, between January 2-10.