Background Check

We appreciate you taking the time to fill this out. 

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* Required information.

 

 

 

**Please only fill this out if you are going to be a COUNSELOR for American Legion Boys / Girls State. Delegates DO NOT fill this out**

 

 

 

 

Date * 1000
First Name *
Full Middle Name *
Last Name *
Street Address *
City *
State *
Zip Code *
List Any Previous Names
Date Of Birth *
Social Security # *
Sex *
Driver's License # *
State *
Have you ever been convicted of a crime ? *
If Yes, Please Explain

Please list any previous addresses for the past 10 years.

Address
City, State & Zip Code

 

Criminal background checks may be conducted on volunteers. I authorize the American Legion Boys / Girls State (ALBS / ALGS) to conduct such a check. I release the ALBS / ALGS and its employees from any claims arising out of a criminal background check. If a determination is made that a person may not serve as a volunteer due to the criminal background check, I may inspect and challenge the information received by the ALBS / ALGS.

 

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