Pursuant to 1993 Public Act 68, by checking to agree to terms, I represent that I have not been convicted of, or pled guilty (no contest) to any crimes, not including civil infractions. In the event that I have been convicted or pled to any crime, I agree to disclose such information on this form. I realize that failure to disclose will automatically result in preclusion of volunteer activities regardless of the nature or age of the conviction.
By checking to agree to terms, I further assert that I have never plea bargained or been convicted of criminal sexual conduct of any degree, assault with the intent to commit criminal sexual conduct, or an attempt to commit criminal sexual conduct in any degree, felonious assault involving a child, child abuse in any degree, or attempt to commit child abuse in any degree, torture, or indecent exposure involving a child; or a violation of Section 7410 or 7416 of the Public Health code.
Lastly, by checking to agree to agree to terms, I signify that I understand that the Board of Education must request a criminal history check on me from the Criminal Records Division of the Michigan Department of State Police and that report is received and reviewed by the District, I am regarded as a conditional volunteer employee; and if the report is received is contrary to my representations above, my services will be voided by the District.