THE SAFETY OF CHILDREN IN UNIVERSITY PROGRAMS | SAFETY OF CHILDREN IN UNIVERSITY PROGRAMS

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773.702.8837 kenyatta@uchicago.edu

Safety of Children in University Programs
Policy
Checklist for Compliance
Q&A: The Policy
Q&A: Background Checks
Register Your Program
Required Training
Request Background Checks
Rules of Conduct
Acknowledgments Form
Message to Parents of Minors
Message to Minors on Campus
Contact Us
Office of Risk Management
Staff Profile
Resources

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PLEASE REGISTER YOUR PROGRAM

Please Register Your Program

Name Of Program

Contact Person

Contact Person’s Email Address

Contact Person’s Phone Number

Program Sponsor

Center For Leadership And Involvement

The University Of Chicago Community Service Center

Neighborhood Schools Program

Other, Please Indicate Department And/Or Unit

Entity Not Associated With The University of Chicago

If Non-UChicago Entity, Please Indicate Name Of Entity

If Non-UChicago Entity, Does Entity Have A Site Agreement?

Yes

No

Overnight Activity?

Yes

No

Program Start Date

Program End Date

How Many Minors Will Be Served?

What University Locations Will Be Used To Host Minors?

Ages Of Minors

5 years and under

5-8 years old

9-12 years old

13-15 years old

16-17 years old

How Many Persons Will Have Direct Contact With Minor(s)?

Name Of Person With Direct Contact With Minor

Email Address Of Person With Direct Contact With Minor

Name of Person With Direct Contact With Minor

Email Address

If There Will Be More Than Two Persons With Direct Contact With Minor, Please List Names and Email Addresses

Have The Persons With Direct Contact With Minors Completed A Background Check?

Yes

No

Yes, upon hire

All persons that will have direct contact with minors are required to undergo a background check. Please use the form below to submit names and email addresses of persons that are required to have a background check. Upon completion of the form, please submit the form to kenyatta@uchicago.edu

Background check form

PLEASE SUBMIT YOUR PROGRAM REGISTRATION

*”Direct Contact” means to provide instruction, care, supervision, guidance to, or oversight and/or control over children through a covered program.

kenyatta@uchicago.edu
773.702.8837

Office of Risk Management
University of Chicago Levi Hall
5801 South Ellis
Third Floor North
Chicago, Illinois 60637

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