District 7570 Youth Protection Background Submission Form

District 7570 Youth Protection Background Submission Form
When is a Background Check Needed

A volunteer is defined as any adult involved with Rotaract or Rotary Youth activities, who has a supervisory role or significant interaction with students. This includes Rotarians, parents, school officials, and volunteers. If you will be alone with a student - You will need a background check!

Inquiries as to the necessity of a background check should be made to the Youth Protection Officer, Mike Mondul, mondums@danvilleva.gov

Important - Before you complete this form, click this link to see if you already have a background check that has not expired. If you have one that has not expired, note the future expiration date and request a new one if needed at that time.
Is the only reason you need a background check because you are chaperoning at RYLA?

Name

First NameMiddle NameLast Name
Why do you need a background check
Rotary Capacity
Include what capacity you are requesting a background check
Email (volunteer needing background check)
example@example.com
Mobile Cell Phone (to receive a text alert reminder for background submission)
Please enter a valid phone number.Format: (000) 000-0000.
Email of person submitting the form
example@example.com
Thank you for volunteering to serve as a RYLA Chaperone!

You do not need to complete this form. Once your chaperone application has been approved, your information will be collected separately to initiate the required background check.
The Rotary Club of:
PeopleTrail - Background Checks

The Rotary Club will be billed $19.99 by District 7570. Background checks are valid for 2 years. The District Representative will enter the request to PeopleTrail. The volunteer will be sent an email from InstaScreen with a link to a secure website to submit further information. The volunteer should check email spam/junk folder daily for InstaScreen email. The link in the email will expire in 14 days.
Should be Empty:

PeopleTrail - Background Checks