Fingerprint / Background Check

The cost of this background check ($20 for certified teachers, $35 for all others) must be paid at the time of service.

Authority: The FBI’s acquisition, preservation, and exchange of fingerprints and associated information is generally authorized under 28 U.S.C. 534. Depending on the nature of your application, supplemental authorities include Federal statutes, State statutes pursuant to Pub. L. 92-544, Presidential Executive Orders, and federal. Providing your fingerprints and associated information is voluntary; however, failure to do so may affect completion or approval of your application.

Social Security Account Number (SSAN). Your SSAN is needed to keep records accurate because other people may have the same name and birth date. Pursuant to the Federal Privacy Act of 1974 (5 USC 552a), the requesting agency is responsible for informing you whether disclosure is mandatory or voluntary, by what statutory or other authority your SSAN is solicited, and what uses will be made of it. Executive Order 9397 also asks Federal agencies to use this number to help identify individuals in agency records.

Principal Purpose: Certain determinations, such as employment, licensing, and security clearances, may be predicated on fingerprint-based background checks. Your fingerprints and associated information/biometrics may be provided to the employing, investigating, or otherwise responsible agency, and/or the FBI for the purpose of comparing your fingerprints to other fingerprints in the FBI’s Next Generation Identification (NGI) system or its successor systems (including civil, criminal, and latent fingerprint repositories) or other available records of the employing, investigating, or otherwise responsible agency. The FBI may retain your fingerprints and associated information/biometrics in NGI after the completion of this application and, while retained, your fingerprints may continue to be compared against other fingerprints submitted to or retained by NGI.

Routine Uses: During the processing of this application and for as long thereafter as your fingerprints and associated information/biometrics are retained in NGI, your information may be disclosed pursuant to your consent, and may be disclosed without your consent as permitted by the Privacy Act of 1974 and all applicable Routine Uses as may be published at any time in the Federal Register, including the Routine Uses for the NGI system and the FBI’s Blanket Routine Uses. Routine uses include, but are not limited to, disclosures to: employing, governmental or authorized non-governmental agencies responsible for employment, contracting licensing, security clearances, and other suitability determinations; local, state, tribal, or federal law enforcement agencies; criminal justice agencies; and agencies responsible for national security or public safety.

Additional Information: The requesting agency and/or the agency conducting the application investigation will provide you additional information pertinent to the specific circumstances of this application, which may include identification of other authorities, purposes, uses, and consequences of not providing requested information. In addition, any such agency in the Federal Executive Branch has also published notice in the Federal Register describing any systems(s) of records in which that agency may also maintain your records, including the authorities, purposes, and routine uses for the system(s).

I grant permission for Alpine School District to request personal and employment references from those listed and certify that I can, and will upon request, substantiate all statements made on this application and that such statements are true, complete to the best of my knowledge and are made in good faith. I understand that any false statements or deliberate material omissions shall be sufficient cause for dismissal or disqualification from employment consideration. Submission of this form certifies that I hereby expressly authorize the Board of Education, its agents, and its employees to investigate my personal or employment history, expressly including but not limited to federal and/or state criminal, law enforcement, or traffic records, which may include confirmation by fingerprint identification. I give my permission for the Superintendent or designee to provide on request from future prospective employers any information relating to employment with Alpine School District.

Alpine School District is an Equal Opportunity Employer. Your application will not be rejected because of your race, color, national origin, religion, sex, or age except as legally required and indicated on the vacancy notice. No individual with a disability who, with reasonable accommodation, can perform the essential functions of the offered position, shall be discriminated against.

By clicking below, I acknowledge that I agree with the above terms and conditions.

I understand that my personal information including name, date of birth, Social Security number and fingerprints will be used for the purpose of conducting a criminal history records search through any applicable state and federal databases. This information will be used by Alpine School District to determine my eligibility for the position I have applied for. My personal information and fingerprints may be retained for ongoing monitoring and comparison against future submissions to the state, regional or federal database and latent fingerprint inquiries. Alpine School District will establish procedures to ensure removal of my fingerprints from applicable state and federal databases when I am no longer under their purview. I understand that I may request to review any results of this inquiry and understand that UCA 53G-11-402 does not allow Alpine School District to provide a copy of those results to me. Before a determination is made, I understand that I will be afforded a reasonable amount of time to challenge the completeness and accuracy of the record through the procedures established by Alpine School District as well as contacting the Utah Bureau of Criminal Identification (Utah Criminal History Results), the State Identification Bureau (SIB) associated with any results that are outside of Utah, or the Federal Bureau of Investigation (Nationwide Criminal History Response Information). Until the completion of the background check, I understand I may be denied unsupervised access to children, vulnerable adults or to the privilege in which the background check pertains to. I will provide a list of all criminal convictions which contains a description of the crimes and the particulars of the convictions. I have read the Privacy Statement provided and understand my rights according to this statement.

I hereby authorize Alpine School District to investigate my past and present work, education, and law enforcement records to ascertain any and all information which may be pertinent to my employment qualifications with the district. I do hereby release all persons, firms, agencies, companies, groups or installation, whosoever, from any damages of, or resulting from, furnishing such information. I further agree that a copy of this release shall function as an original. As of November 1, 2015, all employees will only need to submit to one background check as long as they are actively employed by Alpine School District. This will be an ongoing background check.

In the event your application for employment with the District is denied as a result of information obtained through the criminal background check, you will receive written notice of the reasons for denial. You will also be given an opportunity to respond to the denial or termination. This notice is provided pursuant to UCS 53-A-3-410(2).

Alpine School District is an Equal Opportunity Employer. Your application will not be rejected because of your race, color, national origin, religion, sex, or age except as legally required and indicated on the vacancy notice. No individual with a disability who, with reasonable accommodation, can perform the essential functions of the offered position, shall be discriminated against.

Please contact the Human Resource Office with any questions.

I understand that my personal information including name, date of birth, Social Security number and fingerprints will be used for the purpose of conducting a criminal history records search through any applicable state and federal databases. This information will be used by Alpine School District to determine my eligibility for the position I have applied for. My personal information and fingerprints may be retained for ongoing monitoring and comparison against future submissions to the state, regional or federal database and latent fingerprint inquiries. Alpine School District will establish procedures to ensure removal of my fingerprints from applicable state and federal databases when I am no longer under their purview. I understand that I may request to review any results of this inquiry and understand that UCA 53G-11-402 does not allow Alpine School District to provide a copy of those results to me. Before a determination is made, I understand that I will be afforded a reasonable amount of time to challenge the completeness and accuracy of the record through the procedures established by Alpine School District as well as contacting the Utah Bureau of Criminal Identification (Utah Criminal History Results), the State Identification Bureau (SIB) associated with any results that are outside of Utah, or the Federal Bureau of Investigation (Nationwide Criminal History Response Information). Until the completion of the background check, I understand I may be denied unsupervised access to children, vulnerable adults or to the privilege in which the background check pertains to. I will provide a list of all criminal convictions which contains a description of the crimes and the particulars of the convictions. I have read the Privacy Statement provided and understand my rights according to this statement.

I hereby authorize Alpine School District to investigate my past and present work, education, and law enforcement records to ascertain any and all information which may be pertinent to my employment qualifications with the district. I do hereby release all persons, firms, agencies, companies, groups or installation, whosoever, from any damages of, or resulting from, furnishing such information. I further agree that a copy of this release shall function as an original. As of November 1, 2015, all employees will only need to submit to one background check as long as they are actively employed by Alpine School District. This will be an ongoing background check.

In the event your application for employment with the District is denied as a result of information obtained through the criminal background check, you will receive written notice of the reasons for denial. You will also be given an opportunity to respond to the denial or termination. This notice is provided pursuant to UCS 53-A-3-410(2).

Please contact the Human Resource Office with any questions.