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2. Application for Universal Background Check
6. First Name*
7. Middle Initial
8. Last Name*
10. Suffix (SR, JR, II, IV, etc)
11. Maiden Name/Alias*
13. Sex*
    -- Select One --MaleFemale
14. Race
    -- Select One --Asian or Pacific IslanderWhiteBlackAmerican IndianAlaskan NativeUnknown
16. Date of Birth*
    Date of Birth
17. Social Security #*
19. Address*
21. City*
22. State*
23. Zip Code*
25. Email Address*
27. Which Sport Are You Looking To Volunteer In?*
31. CONSENT FOR BACKGROUND SCREENING & INVESTIGATION
    • I authorize “The Borough of Paramus / Recreation Department” to conduct a criminal background investigation through it’s authorized official agencies and affiliates as part of its volunteer screening and/or selection process.
    • I certify that all statements and answers set forth on this application form are true, accurate an complete to the best of my knowledge. I understand that following my volunteer term should any statements or answers be found to be false or information has been omitted , such false statements or omissions will be just cause for immediate termination of my volunteer status and term.
35. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
37. Electronic Signature*
38. Date*
    Date
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40. 1. Receive an email copy of this form.
41. Email address

    This field is not part of the form submission.

42. Submit Submit and Print

* indicates a required field