Declaration of Application of Police Record Check (Orono Amateur Athletic Association)

Print Declaration of Application of Police Record Check

This form is to be submitted by bench staff who require a Police Record Check and have applied for it from their local police department and are waiting for it to arrive. All the information submitted is confidential and for sole use of the OAAA for screening of volunteers with the organization.

Person Submitting Form

Full Name^*
Team^*

The team you are volunteering with
Position ^*

Your position with the team

Date of Form Submission^*

Open the calendar popup.

Police Service Application Submitted To

Date Police Record Check Applied For^*

Open the calendar popup.

What day did you apply for your Police Record Check

Police Department ^*

What police department did you apply to get your PRC from?

Declaration of Criminal/No Criminal Record 20

Criminal Record Declaration^*
I hereby state that I do not to my knowledge have any criminal convictions
I hearby state that I do have criminal convictions (see next question for details)
If you advised you have criminal convictions, please list them here with the date of conviction if known

Enter your criminal convictions here