Operation Orphans

	Operation Orphans Volunteer Background Check Release Form

BY SUBMITTING THIS APPLICATION YOU ARE AUTHORIZING A CRIMINAL BACKGROUND CHECK OF YOURSELF. THIS CHECK WILL BE MADE FROM PUBLIC RECORD SOURCES. YOU WILL HAVE AN OPPORTUNITY TO REVIEW AND CHALLENGE ANY ADVERSE INFORMATION DISCLOSED BY THE CHECK. THANK YOU FOR GIVING YOUR TIME TO OPERATION ORPHANS If you would like a copy of your background check, please send an email to info@operationorphans.org to request this information.

Note: The information obtained in this application if for the internal use of Operation Orphans only. In order to approve your application, we need ALL the following information–please leave nothing blank.

Full Name:

First: MI: Last:

Birth Date (mm/dd/yyyy):

Social Security Number:

- -

E-mail Address:

Home Phone Number:

- -

Cell Phone Number:

- -

Home Address:

City, State & Zip Code:

Driver's License # and State of Issuance:

Texas Hunter Safety # and State of Issuance:

Gender:

Male Female

Employeer:

Employeer Address:

City, State & Zip Code:

Do you use illegal drugs?

Yes No

Have you ever been convicted of a criminal offense?

Yes No

If you answered "Yes" to the question above, please describe:

Have you ever been charged with child neglect or abuse?

Yes No

If you answered "Yes" to the question above, please describe:

Has your driver’s license ever been suspended or revoked?

Yes No

If you answered "Yes" to the question above, please describe:

Other than the above, is there any fact or circumstances involving you or your background that would call into question your being entrusted with the supervision, guidance, and care of young people?

Yes No

If you answered "Yes" to the question above, please describe:

Are you a volunteer guide for a
ranch that hosts our young hunters?

Yes No

If you answered "Yes" to the question above, which ranch do you guide for?

By submitting this form, I understand that:

The information that I have provided may be verified, if necessary by contacting persons or organizations named in this application, or by contacting any person or organization that may have information concerning me. I understand Operation Orphans will conduct a criminal background check on me. I hereby release and agree to hold harmless from liability any person or organization that provides information. I also agree to hold harmless the directors, trustees, employees, and volunteers of Operation Orphans.
In signing this application, I have read the attached information and apply to be a volunteer with Operation Orphans. I agree to comply with the Rules and Regulations of Operation Orphans. I affirm that the information I have given on this form is true and correct.

To electronically submit this background check release form, type in your first and last name as an electronic signature below. The electronic transmittal of this document shall not affect the legal effect, validity or enforceability of this document.
Electronic Signature:

OPERATION ORPHANS PRIVACY POLICY: Operation Orphans protects the confidentiality of the names and personal information of those who are affiliated with the organization. No commercial or unauthorized use is made of the names, addresses, and other confidential information of Operation Orphans volunteers. Access to this information is strictly limited.

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