Blackhawk Christian School (BCS) requires applicants, employees, and volunteers to submit to a criminal background investigation as part of the hiring/volunteer process. The investigation is performed at the school’s expense.

Please complete the Criminal History Affidavit below, authorizing the school to perform a criminal background check. This affidavit, together with the final report, will be maintained in our applicant and personnel files.

I affirm that I have never been convicted of any of the following offenses involving children or otherwise in Indiana or any other state:

1. Rape (as defined in IC 35-42-4-1).
2. Criminal deviate conduct (as defined in IC 35-42-4-2).
3. Child molesting (as defined in IC 35-42-4-3).
4. Child exploitation (as defined in IC 35-42-4-4).
5. Vicarious sexual gratification (as defined in IC 35-42-4-5).
6. Child solicitation (as defined in IC 35-42-4-6).
7. Incest (as defined in IC 35-46-1-3).
8. Child selling (as defined in IC 35-46-1-4).
9. Child seduction (as defined in IC 35-42-4-7).
10. Sexual battery (as defined in IC 35-42-4-8).
11. Felony charges within the last 5 years, convictions in the last 10.
12. Battery charges within the last 5 years, convictions in the last 10.
13. Drug charges within the last 5 years.
14. Two or more alcohol related charges within the last 5 years*.
15. Any charge currently pending.

Furthermore, I also affirm that I have never been charged with any of the crimes listed above and had the charges plea-bargained to an offense not listed above. I also give my consent for BCS to initiate a criminal background check and to check my driving record, if applicable, with the Bureau of Motor Vehicles.