background check filed with their home congregation. Name: ________________________________________________________________ Other names by which you have been known over the past five years: _______________________________________________________________________ Date of birth: _______________ Social Security Number: ______________________ Current Address: _______________________________________________________ CITY STATE ZIP Current Phone Number: ____________________________________________.
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How to fill out the Lower Susquehanna Synod Youth Event Voluntary Disclosure Statement online
The Lower Susquehanna Synod Youth Event Voluntary Disclosure Statement is a crucial document for adult personnel participating in youth events. This guide provides clear and supportive instructions on completing the form online.
Follow the steps to successfully fill out the disclosure statement.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Enter your name in the designated field, making sure to include any other names you have been known by in the past five years in the appropriate area.
- Fill in your date of birth and Social Security number accurately in the respective fields.
- Provide your current address, including city, state, and zip code, ensuring it is complete.
- Input your current phone number, selecting the appropriate category (home, work, or cell).
- Enter your driver's license number along with the issuing state and expiration date.
- Respond to the questions regarding past accusations or convictions of crimes against minors by circling 'YES' or 'NO'. If you answer 'YES' to any question, provide a detailed explanation in the space provided.
- Answer the questions related to civil penalties involving abuse, court orders, and parental rights termination, circling 'YES' or 'NO', and providing explanations where required.
- Review the understanding section carefully to ensure you are aware of the implications of your answers.
- Sign and date the form in the designated area. If you are under 18, a parent or legal guardian should also sign and date the form.
- Once all fields are completed, save the changes. You may download, print, or share the form as necessary.
Complete your documentation online today to ensure a smooth experience at your youth event.
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