R22 Child abuse clearances Document Upload
Name
*
First Name
Last Name
Email
*
example@example.com
Link for clearances:
https://www.dhs.pa.gov/KeepKidsSafe/Clearances/Pages/PA-Child-Abuse-History-Clearance.aspx
I would like to upload:
*
PA state criminal background check
PA Childline Screen
FBI fingerprint check
PA affidavit (volunteers who live in PA last 10 years)
PA State Criminal Check Date
-
Month
-
Day
Year
Date
PA state Criminal Check certification number
Please upload PA state Criminal Background Check
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of
PA Childline Check Date
-
Month
-
Day
Year
Date
PA Childline certification number
Please upload PA state ChildLine clearance
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of
Are you a volunteer who has live in Pennsylvania for the last 10 consecutive years?
FBI fingerprint Check Date
-
Month
-
Day
Year
Date
FBI fingerprint Check certification number
Please upload FBI fingerprint clearnace
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Cancel
of
Upload 10 year affidavit (volunteers only)
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of
Save
Submit
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