2-Background FY25 (1).pdf

Alpine School District School Board Policy 4457 states:

1.1 School Authorities are charged with protecting the health and safety of all students. As a means of helping to fulfill this charge, Alpine School District requires prospective employees to have a criminal background check.

1.5 Applicants who have been CONVICTED of any felony shall not be hired by Alpine School District. Applicants who have been convicted of any job related misdemeanor shall be reviewed and may not be hired by Alpine School District.

It will be required of all contractors and sub-contractors to comply with this policy by submitting necessary information on all employees working on the project. District representatives will need a Criminal History Record through the Bureau of Criminal Identification, a division of the Utah

Department of Public Safety, for all employees. https://bci.utah.gov/criminal-records/criminal records-forms/ The employees must pass the background check to be eligible to work on projects on any Alpine District Property occupied by students. An Application for Criminal History Record Application will need to be filled out and sent to BCI with a fee. Fingerprints will need to be taken by a law enforcement agency such as your city police depa1tment, county sheriffs office or BCI 3888 West 5400 South, Taylorsville, Utah as pa1t of the Application. A Third Party Release Form will also need to be filled out and given to BCl with Alpine School District as the Agency and Frank Pulley Jr. as the Person to receive the repmt. Upon receiving this report, the District will issue a clearance card to be carried on job sites. The clearance card does not expire unless BCJ notifies District of infraction.

Instructions for Application for Criminal History Record

Enclosed is an application for Criminal History Record from the State of Utah, Department of Public Safety, Bureau of Criminal Identification. Please complete all of the steps described below. Failure to properly complete one of the steps may cause a delay in processing your application.

1. Fill out the top portion of the application. List all of your previous names including maITied and maiden names. Be sure to read and sign the application.

2. Take the application to a law enforcement agency such as your city police depa11ment or county sheriffs office. Request that they print the four fingers of your right hand on the space provided.

Make sure the law enforcement official who takes your fingerprints fills out the portion of the application labeled "OFFICIAL TAKING PRINTS." Valid government-issued photo ID must be provided to the official taking your prints (for example, passport, state ID card, consulate ID card, and driver license.) "Utah Driving Privilege Cards" WILL NOT be accepted by BCI as valid

ID. Driving Privilege Cards state on them that they are not to be used as ID. NOTE: The fingerprints may be taken at our office, Bureau of Criminal Identification, 3888 West 5400 South, Taylorsville, Utah.

3. The application fee is $20.00. Select a method of payment by making a check mark in the appropriate box. Checks and money orders must be US CuITency and be made payable to "Utah Bureau of Criminal Identification." To pay by credit card (Visa, MasterCard, Discover Card or AMEX), please fill out the requested infmmation on the application. Credit card numbers must include: the signature of the cardholder, the three-digit control number located on the back of the card, the expiration date, and the zip code of card billing address; sorry we cannot accept credit cards outside of the US. Cash is accepted only when applying in person. DO NOT SEND

CASH IN THE MAIL.

4. Yow- repo11 will be mailed to the mailing address indicated on the application form. If the infonnation needs to be sent to a third party, the third party release form must. be filled out and submitted along with your application.

5. Mail the application, fee and release form (if applicable) to:

UTAH BUREAU OF CRWINAL IDENTIFICATION

3888 West 5400 South Taylorsville, Utah 84129

The report cannot be faxed or sent by e-mail.

If you have questions you may call (801) 965-4445 from 8:00 AM - 5:00 PM Monday-Friday.

Our office is closed weekends and holidays.

You may also visit our website at http://publicsafety.utah.gov/bci/

The Bureau of Criminal Identification does not maintain juvenile offender records.

Requests for such records must be made directly to the Juvenile Court.

R

APPLICATION FOR CRIMINAL HISTORY RECORD

Utah Department of Public Safety • Bureau of Criminal Identification

3888 West 5400 South, Taylorsville, Utah 84129 - Telephone: (801)965-4445 form 98-1-03, Re\' -1/2019

WHEN FILLING OUT THIS APPLICATION TYPE OR PRINT IN BLACK INK. Your application will not be processed unless all sections of this form are filled out completely. You will need a valid fo1m of government issued picture ID and $15.00 fee.

NAME: DATE OF BIRTH

(las/ Name) (Firs/ Name) (Middle Name)

PREVIOUSLY USED NAME(S) (Maiden, etc.):

MAILING ADDRESS:

(Stree1/Box 1111111ber) (Cily)

PHYSICAL ADDRESS:

(S!Me) (Zip)

(S1reec) (Ci1y) (S!ale) (Zip)

HOME PHONE NUMBER: DAYTIME PHONE NUMBER:

SOCIAL SECURITY: DRIVER LICENSE# AND STATE:

PHYSICAL DESCRIPTION: HGT/ WGT/ EYE COLOR/ SEX/ RACE/

I hereby declare that I am the person listed above and am entitled to my criminal record as provided by Utah Code Ann. § 53- I 0-108(9)(a).

The information contained in this written statement is true and correct to the best of my knowledge and I w1derstand that any false statements r make that I do not believe to be true may subject me lo criminal punishment as a class B misdemeanor pursuant to Utah Code Ann. §76-8-504.

Signature of applicant: Date:

FINGERPRINT INSTRUCTIONS: (OFFICIAL TAKING PRINTS) Confim1 identity of applicant with identification that shows photo, signature and date of birth. Confirm ID with the information above, then list the type of government isSLLed ID used and the ID number in the space provided below. Fingerprint the four fingers of the applicant's r ight hand simultaneously in the box located in the lower right portion of this fonn.

This Arca must be completed by OFFICIAL TAKING PRINTS FINGERPRINTS

Type of identification used:

(Utah Driving Privilege Cards are 11of valid ID mid will 11ot be accepted)

Identification number:

Name on ID :

Fingeiprints taken by:

(PRINT NAME)

Agency Name:

Badge# Date Printed:

(If applicable)

BUREAU USE ONLY AFIS Confirmation

SID# R&F

METHOD OF PAYMENT (Only to be filled out if application is mailed in. Check appropriate box for payment)

[ Check, Money Order or Cashier's Check (Payable to "BC!") There will be a $20.00 service charge for any returned check.

fl Credit Card (cannot use foreign credit cards) must be [l Visa n Master Card l Discover n AMEX Fill out the information below to pay by credit card. *3 or 4 digit control ti Exp Date MM/YY

Cardholdcr signature: Zip Code Associated with Credit Card:

THIRD PARTY RELEASE FORM

Utah Depa1tment of Public Safety• Bureau of Criminal identification 3888 West 5400 South, Taylorsville, Utah 84129

WHEN FILLING OUT THIS FORM, TYPE OR PRINT IN BLACK INK. If you wish to have your criminal history record or certificate of eligibility sent to an individual other than yourself, you must indicate the name of the person or agency to whom you would like the document sent and the mailing address.

NAME: Physical Facilities/Frank Pulley Jr.

(Name of Person to Receive Report)

AGENCY: Alpine School District

490 North State St. Ste I 02

MAILING ADDRESS:

Lindon

(Street/Box number) (City)

(if applicable)

Utah

(Slate)

84043

(Zip)

I request that the criminal history record or certificate of eligibility for which I applied be released to the individual or agency indicated above at the listed address. I hereby release the Bureau of Criminal Identification from any liability resulting from such release.

Name of applicant (Prinl): ________________________ _

Signature of applicant: ___________________________ Date: