HOPE Volunteer Background Check Authorization and
Consent Form!
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!Please Print or Type Name
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Name:
________________________________________________________________
(Last) (First) (Middle)
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Date of Birth:
___________________________________________________________
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Email Address:
_________________________________________________________
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Current Address:
________________________________________________________
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City/State/Zip:
__________________________________________________________
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Signature: __________________________________ Date: ________________
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Print Name:
____________________________________________________________
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HOPE shall maintain all information received from this authorization in a
confidential manner in order to protect the volunteer’s personal information,
including, but not limited to, addresses and dates of birth.
Revised 04/18/25