Volunteer Information

Volunteer Background Check

State of Michigan ICHAT

To ensure the protection of all participants of New Hope Center for Grief Support, our policy requires that all potential volunteers to complete a State of Michigan ICHAT background check. Any applicant declining to complete a "Volunteer Background Check," the acknowledgement form will not be considered.

* Required Fields

Information needed

Full First Name

Last Name

Main Phone

Address

Address 2

City

Zip

State

Birthdate

Gender

Hair Color

Eye Color

Height

History Information

Have you volunteered for New Hope Center for Grief Support before?

Have you ever plead guilty, or been convicted of a felony in a state or federal court?

If convicted, date of the offense/conviction.

If yes, provide a detailed description of the conviction.

Have you ever plead guilty, or been convicted of a misdemeanor in a state or federal court?

If convicted, date of offense/conviction.

If convicted state of offense

If yes, provide a detailed description of the conviction.

Are you the subject of a current criminal investigation or have pending charges against you?

If yes, date of the pending charges against you.

If yes, detailed description of the investigation or pending charges.

If yes, state of the pending investigation.

Signature

By affixing your name below, this acknowledges as your signature, and your statements are to be true. You also give full consent to complete the requested background check, and you consent to this report being processed annually.

New Hope Center for Grief Support reserves the right to "approve" or "deny" any volunteer service upon review of the background check returned. The determination will be based upon the individual's fitness to have responsibility for the safety and wellbeing of children. Providing false information is grounds for immediate volunteer denial.

For questions or concerns, please contact our office at 248-348-0115