Background Check Request Form

Congregations of the Presbytery of Wabash Valley can request and receive background checks for any prospective employees and/or volunteers through the presbytery’s Protect My Ministry account.

Name of Congregations Making Request

Name of Person Requesting Background Check

Church Position Held

Name of Person to Receive Final Report

Email (Of Person to Receive Final Report)

BACKGROUND CHECK REQUEST

Name of Person for whom request is made

First name

Last name

Email (For Requested Individual)

Birthdate if Under 18 Years of Age

Month

Day

Year

Parental/Guardian Permission

Yes

Level of background check requested (Fees listed are approximate and subject to change)

BASIC – Limited search (Includes: Address history, National Criminal Database Search; National Sex Offender Search; SSN Trace, Alias Names) $26.95

*Mandatory state, court, and jurisdictional fees may apply to the following:

PLUS/ STANDARD* - (Includes Basic plus County or Statewide Criminal Court Search, Re-verification on all “hits”) $41.95

PREMIER/PREFERRED PLUS CREDIT - Includes Basic and Standard in addition plus, Unlimited County Criminal Court [7yrs]

Please choose the level of background check you are requesting.

Additional Options (Additional mandatory state, court, and jurisdictional fees may apply)

Consumer Credit Check (for those entrusted with finances)

Driving History (for vehicle use)

The forms above require the address of the person whom request is being made. Please provide that below.

Address

Please allow up to seven days (7) to receive report.
Invoice will be emailed to church once background check is completed.
Presbytery will not submit a written report without the permission of the individual whose background check was requested.
Reports are reported as clear/clean or when necessary, list areas of concern.
The Presbytery of Wabash Valley does not save or print out background checks.