Revised 06/26/2024 – Page 1 of 2
God’s HandyPeople
Authorizaon to Conduct Background Checks
To promote a safe environment for individuals and families receiving assistance from God’s HandyPeople, its
volunteers, and its employees, background checks are required for volunteers and employees. Background
checks also provide God’s HandyPeople with vital informaon needed when determining the general ability of an
individual to volunteer or be employed, thus helping to ensure the protecon of those served, other volunteers.
And employees, and the organizaon overall. Please provide the requested informaon and signature below.
Name: _____________________________________________________________________________________
Other name(s) including maiden: ________________________________________________________________
Street Address: ______________________________________________________________________________
City, State, Zip: ______________________________________________________________________________
Email: __________________________________________________Mobile Phone: ______________________
Address/es lived outside of Michigan during the past ve years:
Street Address: ______________________________________________________________________________
City, State, Zip: ______________________________________________________________________________
I hereby authorize God's HandyPeople and its designated representave(s) to conduct a comprehensive review
of my background. I understand the scope of the background check will minimally include the following records
checks. Addionally, the background check may include an applicaon and interview.
• Michigan State Police – Internet Criminal History Access Tool (ICHAT)
• Michigan Public Sex Oender Registry Check (PSOR)
• Dru Sjodin Naonal Sex Oender Public Website (NSOPW)
• Michigan Department of Health and Human Services (MDHHS) Central Registry (CR) Check
If I have not lived in Michigan for the past ve years, I also authorize God's HandyPeople to conduct a Naonal
Crime Informaon Data (NCID) Criminal Record Check.
I authorize the sharing of informaon with GHP and release all agencies including the Michigan Department of
Health and Human Services, and local, state, and naonal law enforcement agencies, from all liabilies that may
result from any disclosure made in response to this request. I further waive any wrien noce of the release of
such records that may be required by state or federal law. And I specically release from liability, representaves,
employees, ocers, and/or directors of these agencies for providing informaon and/or records to GHP.
I cerfy that the above informaon is true and complete to the best of my knowledge. I further acknowledge
that the facsimile or photocopy of the documents shared be valid and accepted with the same authority as the
original. This authorizaon will remain in eect throughout the term of my volunteering or employment and
during the me that God’s HandyPeople retains the informaon noted above, documents provided, and results
of the background checks.
Signature: _____________________________________________ Date: _____________________
A background check has been performed on the above-named volunteer/employee and no material or applicable
charges were found against him/her, Therefore, this person is permied to serve as a qualied
volunteer/employee for God's HandyPeople.
Approved by: _____________________________________________ Date: _____________________