Step 1 of 2 50% Background Investigation ConsentPlease complete the Background Investigation Consent form below and submit a $10 processing fee. If you are under age 18, you are not required to complete the Background Investigation Consent form. NO REFUNDS WILL BE ISSUED ON PROCESSING FEES. You will not be considered for a volunteer position until the volunteer coordinator receives your completed form and the background payment. We will only follow up with you if there is an issue to address with your background check. I hereby authorize the International Institute of St. Louis and/or its agents to make an independent investigation of my criminal or police records, including those maintained by both public and private organizations and all public records for the purpose of confirming the information contained on my Application and/or obtaining other information which may be material to my qualifications for volunteering now and, if applicable, during the tenure of my volunteer commitment with the International Institute. By submitting the $10 processing fee, I release the International Institute of St. Louis and/or its agents and any person or entity, which provides information pursuant to this authorization, from any and all liabilities, claims or law suits in regards to the information obtained from any and all of the above referenced sources used. The following is my true and complete legal name and all information is true and correct to the best of my knowledge: Volunteer Full Legal Name* Email* Permanent Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificState ZIP Code How long have you lived at this address?* Date of Birth* Month Day Year Social Security Number*Driver's License Number*State of License*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificDate* MM slash DD slash YYYY **Please contact John Worth if you do not have a social security number or if you do not possess a driver’s license. *The above information is required for identification purposes only, and is in no manner used as qualifications for volunteering. Date of Birth, Social Security Number and Driver’s License Number are encrypted. Background Investigation Consent PaymentBackground Processing Fee Price: Total $0.00 Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Expiration Date Security Code Cardholder Name EmailThis field is for validation purposes and should be left unchanged. Δ