Background Check - SMART Reading

Thanks for completing SMART’s volunteer application. Before you can volunteer at a school, we also need you to authorize and provide information for a background check.

Step 1 of 2

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National Criminal Background Check
To ensure the safety of the children, all volunteer applicants 18 and older must complete this section before the application can be processed. Your cooperation is greatly appreciated.
Legal First Name*
Middle Name
Legal Last Name*
Former Surnames Used
if applicable
Birth Date*

mm/dd/yyyy
Email*
Mailing Address*
Street Address Address Line 2 City State ZIP Code

Authorization and Release
I understand that before I can volunteer, SMART Reading and the entities it serves (Host Sites) conduct a a criminal background check on me. I hereby authorize SMART Reading and any of its Host Sites to conduct a criminal background check on me and to communicate the results of the criminal background check to SMART Reading. I understand that the criminal background check may be conducted by any one or more methods, including without limitation, using government and private databases and services. I understand that a criminal background check may be undertaken at any time, and may be repeated from time-to-time, while I am associated with SMART Reading.

Background checks are conducted by SMART Reading may be done either by Intellicorp Records or Criminal Information Services.

I hereby release and hold harmless SMART Reading, its Host Sites and their respective employees and agents from any and all liability whatsoever arising from or relating in any way to: any person or entity conducting the criminal background check; the disclosure of information resulting from the criminal background check; and any action which may be taken by any individual or entity based upon that information.

I understand that convictions will not necessarily bar me from serving as a SMART Reading volunteer, but it will be reported to the school principal or Host Site for volunteer authorization.
Authorization*
- I have read and understand and commit to the terms stated above. I declare that my answers and all statements made by me herein are true and correct.
Digital Signature
Full Legal Name*
Today's Date*

mm/dd/yyyy
SMART Reading is an equal opportunity employer and does not discriminate on the basis of sex, sexual orientation, age, race, color, religion, marital status, national origin, disability, veteran, or other protected status.

Step 1 of 2

National Criminal Background Check

Authorization and Release

Digital Signature