ABUSE,
POLICIES, AND PROCEDURES FORMS
DISTRICT 5010
NOTE: FPD files are fill in .pdf format. You can fill in the boxes and print the form. You
must have a PDF program in order to save your changes.
1) J51 Criminal Background Check, Policy and Procedures 2P PDF
2) J54 Criminal Background Check Process (
(Please note Item 6 for mailing address)
3) J56 Criminal Background C heck Process (
4) K02 Referral for Suspected Abuse or Neglect 1P PDF
5) K03 Host Family Information Packet (content list) 1P PDF
6) K04 Host Family Application 3P PDF
See information packet K03 above
7) K07 Housing Physical Check List 1P PDF
8) K08 Youth Volunteer Application 3P PDF
9) K11 Consent to Criminal Background Check 1P PDF
Please read J51 and J54 above
This is required for Rotarians and host family members 18
years and older. Complete and mail to the address given.
10) K12 Consent
for Disclosure (
11) K13 Consent
for Criminal Records Check (
12) K14 Youth Exchange Club Commitment Form 2P PDF
13) K16 Club Compliance Certification 1P PDF
REURN HOME
NOVEMBER 17, 2007