College Church of Christ - Volunteer Background Check

Volunteer Area

Today's Date

First Name

Last Name

Birthdate

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Phone Number

Email

Do you authorize College Church of Christ to submit your name to the Arkansas Department of Public Safety for a criminal background check?

Yes

No

Harding University Students: Do you authorize College Church of Christ to contact the Student Life office to determine your standing with Harding University?

Yes

No

I am not a student.

Agreement Statement

I certify that the facts contained in this form are true and complete to the best of my knowledge and understand that if falsified statements are made on this form it shall be grounds for dismissal.

Signature

Agreement Statement

Service Times

Contact Info

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