HR-028, Child Abuse Registry Check Consent Form, revised September 2021-2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin with Section I: Identifying Information. Fill in your first name, middle name, last name, and any maiden or other names used. Ensure accuracy as this information is crucial for the background check.
3. Continue by entering your Social Security Number and Date of Birth in the specified format (mm/dd/yyyy). This data is essential for verifying your identity.
4. In Section II: Current Residence, provide your complete address including city, county, state, and zip code. Include both home and alternate phone numbers along with a personal email address for communication purposes.
5. Move to Section III: Gender / Ethnicity / Race. Select your gender and ethnicity from the provided options. This information helps ensure compliance with diversity standards.
6. Finally, in Section IV: Certification, review all entered information for accuracy. Sign and date the form to certify that the details are correct and grant permission for the background check.

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