SOP_NUMBER: 109.01-att-4
TITLE: Volunteer Services GCIC_NCIC Consent Form
REFERENCE_CODE: VF01-0001
WORD_COUNT: 132
URL: https://gps.press/sop-data/109.01-att-4/

ATTACHMENTS:
  1. Volunteer Service Agreement
     URL: https://gps.press/sop-data/109.01-att-1/
  2. GDC Volunteer Application - Personal Data Sheet
     URL: https://gps.press/sop-data/109.01-att-2/
  3. Sample Request For Identification Card
     URL: https://gps.press/sop-data/109.01-att-3/
  4. Volunteer Services GCIC_NCIC Consent Form
     URL: https://gps.press/sop-data/109.01-att-4/
  5. Visiting Volunteer Waiver of Liability
     URL: https://gps.press/sop-data/109.01-att-5/
  6. Annual Volunteer Services Evaluation
     URL: https://gps.press/sop-data/109.01-att-6/
  7. Volunteer Application Processing Checklist
     URL: https://gps.press/sop-data/109.01-att-7/
  8. Volunteer ID Renewal Certification Validation Form
     URL: https://gps.press/sop-data/109.01-att-8/
  9. GDC OPS Background Screening Packet
     URL: https://gps.press/sop-data/109.01-att-9/

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FULL TEXT:
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SOP 109.01
Attachment 4
6/30/20

VOLUNTEER SERVICES

**GCIC/NCIC CONSENT FORM**


I, ________________________________, hereby authorize the Georgia Department of Corrections (GDC) to
receive any criminal or driver ' s license history information, at any time, pertaining to me which may be in the files
of any state or local criminal justice agency.


Full Name Printed:


Address:


City and State Zip Code Place of Birth


Weight Height Hair Eyes

Sex Race DOB SSN

Applicant’s Signature Date

Approved/Di sapproved (circle one) Comments: _________________________________________

______________________________________________________________   _________________
Appointing Authority’s Signature                                      Date

___________________________________________________________   _________________
Institution/Center/Office Date

**For Ex-offenders ONLY** : Approved/Disapproved by Regional Director

Signature Date

(To be placed in personnel file at Facility)


Retention Schedule: Upon completion, this form shall become part of the volunteer’s file to be maintained for two (2) years
past termination of the volunteer’s services.