Background Check Request Form • Christian Life Church

First Name *

Last Name *

Email Address *

Tip: This email address will be used for background check communication.

Phone Number *

Date of Birth *

Ministry Role / Area of Service (Select all that apply) *

Children & Youth Volunteer (non-leadership)

Children/Youth Leader & Staff

Driver / Transportation Volunteer

Tip: Please select all roles that apply. If you serve with children and drive or transport others, select both options.

Background Check Authorization *

I authorize Christian Life Church to initiate a background check as required for my role.