Acknowledgments Form – Policy on the Safety of Children in University Programs

Persons working for, participating in, or involved with a covered program should create an open, welcoming educational environment, and ensure that the safety and welfare of participating children is a paramount and shared responsibility. Persons working for, or involved with a covered program must submit this acknowledgments form.

 My signature confirms, and I agree:

1. I have read and agree to follow the Policy on the Safety of Children in University Programs.
2. I have completed the Illinois Department of Children and Family Services (DCFS) Training for Mandated Reporters.
3. I have read and agree to follow the Conduct Requirements for Working with Minors.
4. A background check will be completed.
5. I will not have contact with minors in relation to a University Program until all of the above are completed.

Name (print):­­­__________________________________________

Signature:­­­­­­­­­­­­­­­­­­­­­­­­­­­­­_____________________________________________

Date: ________________________________________________

You will soon receive an email from General Information Systems (GIS) inviting you to supply the necessary information for the background check.

Please return the executed (1) Acknowledgments Form and (2) the Certificate of Completion from the DCFS Training for Mandated Reporters, to your (1) program leader and/or HR Partner and to (2) kenyatta@uchicago.edu.