USF Summer Program DCF Clearance Request Form
This form must be completed to begin the USF Summer Program DCF Clearance process. All sections of this form must be completed before USF CHR will initiate the background checks. Incomplete forms will not be accepted and may be returned to the camp/program administrator. This form should only be used to request USF Summer Program Background Checks.
Summer Camp/Program Name:
Dates of Summer Camp/Program:
Will your camp be utilizing USF Residence Halls?
Yes
No
Which Residence Halls will be used?
Camp/Program Director Name:
First Name
Last Name
Camp/Program Director Phone Number:
Please enter a valid phone number.
Format: (000) 000-0000.
Camp/Program Director Email:
example@example.com
Camp/Program Coordinator Name:
First Name
Last Name
Coordinator Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Coordinator Email
example@example.com
Payment Information
Department Name:
Department Number:
Chartfiled information:
Unit
(3 characters)
Fund
(5 characters)
Dept
(6 characters)
Product
(6 characters)
Initiative
(7 characters)
Project
(10 characters)
Participant Information
*
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First Name
Last Name
Email
Status: Employee or Volunteer?
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Are additional participant fields needed?
Yes
No
Participant Information
*
Rows
First Name
Last Name
Email
Status: Employee or Volunteer?
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Submit
Should be Empty: