Volunteer Clearances – Upper St. Clair School District

"*" indicates required fields

Volunteer's Information

Please complete the information below using your legal biographical information (as indicated on your clearance documents)

First Name*

Last Name*

Suffix

Gender*

Date of Birth*

Contact Information

Email Address*

Enter Email Confirm Email

Call Back Number*

This is the phone number that the Upper St. Clair School District will call if they have any questions for you.

Address*

Street Address City State ZIP Code

Affiliation

Role*

School Volunteer

Student Teacher or Observer

Upper St. Clair School District Employee

Contractor

Contractor Name*

Other Name*

Pennsylvania Residency*

I have lived in Pennsylvania for at least the last 10 consecutive years.

Yes

Clearance Data

The following questions require information from your clearance forms. Please have these forms nearby when completing the information in this section.

Pennsylvania Child Abuse History Certification

If you have not completed your Act 151 Pennsylvania Child Abuse History Certification, go to this link: https://www.compass.state.pa.us/cwis/public/home

Page 1

Pennsylvania Child Abuse History Certification - Verification Date*

Pennsylvania State Police Response for Criminal Record Check

If you have not completed your Act 34 Pennsylvania State Police Response for Criminal Record Check, go to this link: https://epatch.state.pa.us/Home.jsp

Page 1

Pennsylvania State Police Response for Criminal Record Check - Date of Request*

Act 114 Criminal History Report

If you have not completed your Act 114 Criminal History Report go to this link: https://uenroll.identogo.com/workflows/1KG6ZJ The requirement to obtain the Act 114 Criminal History Report can be waived if the volunteer is unpaid, can prove that s/he has lived in Pennsylvania for at least 10 years, and signs a Disclosure Statement affirming that s/he did not commit certain crimes elsewhere. Volunteers who have not resided in Pennsylvania for the past 10 years but have obtained their Act 114 Criminal History Report since establishing residency are not required to obtain another Report but must provide a copy of it to the district.

Page 1

Act 114 Criminal History Report - Date of Fingerprinting*

Please provide the date on the approval letter you received from the Department of Human Services.

Volunteer Disclosure Statement

If you have not completed the disclosure statement, go to this link: https://webinfo.uscsd.k12.pa.us/_schoolwires/district/pdf/volunteer-disclosure.pdf

Page 1

Volunteer Disclosure Statement - Date of Certification*