St. Ignatius Schools is a diverse and vibrant educational institution committed to providing a supportive learning environment for all students. We believe in the power of individualized attention and support to help every student reach their full potential.

Position Overview: We are seeking dedicated individuals to serve as volunteers to support our students. As a volunteer, you will work closely with students to provide academic assistance, reinforce learning concepts, and help them achieve academic success. 

All Volunteers must complete a background check for St. Ignatius Schools. 

 

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25 June 12, 2018
Appendix B
Applicant Rights and Consent to Fingerprint
As an applicant who is the subject of a national fingerprint-based criminal history record check for a noncriminal
justice purpose (such as an application for employment or a license, an immigration or naturalization matter,
security clearance, or adoption), you have certain rights which are discussed below.
• You must be provided written notification8 by St. Ignatius Schools that your fingerprints will be used to
check the criminal history records of the FBI.
 You must be provided, and acknowledge receipt of, an adequate Privacy Act Statement when you submit
your fingerprints and associated personal information. This Privacy Act Statement should explain the
authority for collecting your information and how your information will be used, retained, and shared.
• If you have a criminal history record, the officials making a determination of your suitability for
employment, license, or other benefit must provide you the opportunity to complete or challenge the
accuracy of the information in the record.
• The officials must advise you that the procedures for obtaining a change, correction, or updating of your
criminal history record are set forth at Title 28, Code of Federal Regulations (CFR), Section 16.34.
• If you have a criminal history record, you should be afforded a reasonable amount of time to correct or
complete the record (or decline to do so) before the officials deny you the employment, license, or other
benefit based on information in the criminal history record.9
You have the right to expect that officials receiving the results of the criminal history record check will use it only
for authorized purposes and will not retain or disseminate it in violation of federal statute, regulation or executive
order, or rule, procedure or standard established by the National Crime Prevention and Privacy Compact Council.10
If agency policy permits, the officials may provide you with a copy of your FBI criminal history record for review
and possible challenge. If agency policy does not permit it to provide you a copy of the record, you may obtain a
copy of the record by submitting fingerprints and a fee to the FBI. Information regarding this process may be
obtained at http://www.fbi.gov/about-us/cjis/background-checks.
If you decide to challenge the accuracy or completeness of your FBI criminal history record, you should send your
challenge to the agency that contributed the questioned information to the FBI. Alternatively, you may send your
challenge directly to the FBI at the same address as provided above. The FBI will then forward your challenge to
the agency that contributed the questioned information and request the agency to verify or correct the challenged
entry. Upon receipt of an official communication from that agency, the FBI will make any necessary
changes/corrections to your record in accordance with the information supplied by that agency.
If a change, correction, or update needs to be made to a Montana criminal history record, or if you need additional
information or assistance, please contact Montana Criminal Records and Identification Services at
[email protected] or 406-444-3625.
Your signature below acknowledges this agency has informed you of your privacy rights for
fingerprint-based background check requests used by the agency.
Signed:
_______________________________________________ __________
_________________________
Name Date
8 Written notification includes electronic notification, but excludes oral notification.
9 See 28 CFR 50.12(b).
10 See 5 U.S.C. 552a(b); 28 U.S.C. 534(b); 42 U.S.C. 14616, Article IV(c); 28 CFR 20.21(c), 20.33(d) and 906.2(d).

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26 June 12, 2018
NCPA/VCA Applicants
To _________________________________________________________________________________:
You have applied for employment with, will be working in a volunteer position with, or will be providing vendor or contractor
services to (write in Agency or Entity name)____________________________________________________ for the position of
(please be specific)______________________________________________________________________.
The National Child Protection Act of 1993 (NCPA), Public Law (Pub. L.) 103-209, as amended by the Volunteers for Children
Act(VCA), Pub. L. 105-251 (Sections 221 and 222 of Crime Identification Technology Act of 1998), codified at 42 United States
Code (U.S.C.) Sections 5119a and 5119c, authorizes a state and national criminal history background check to determine the
fitness of an employee, or volunteer, or a person with unsupervised access to children, the elderly, or individuals with
disabilities.
1. Provide your name, address, and date of birth, as appears on a document made or issued by or under the authority of
the United States Government, a State, political subdivision of a State, a foreign government, a political subdivision of
a foreign government, an international governmental or an international quasi-governmental organization which,
when completed with information concerning a particular individual, is of a type intended or commonly accepted for
the purpose of identification of individuals. 18 U.S.C. §1028(D)(2).
2. Provide a certification that you (a) have not been convicted of a crime, (b) are not under indictment for a crime, or (c)
have been convicted of a crime. If you are under indictment or have been convicted of a crime, you must describe
the crime and the particulars of the conviction, if any.
3. Prior to the completion of the background check, the entity may choose to deny you unsupervised access to a person
to whom the entity provides care.
The entity shall access and review State and Federal criminal history records and shall make reasonable efforts to make a
determination whether you have been convicted of, or are under pending indictment for, a crime that bears upon your fitness
and shall convey that determination to the qualified entity. The entity shall make reasonable efforts to respond to the inquiry
within 15 business days.
Your Name:
________________________________________________________________________________________________
First Middle Maiden Last
Date of Birth: ________________________________
Address: ________________________________________________________________________________
________________________________________________________________________________
City State Zip
 I have been convicted of, or am under pending indictment for, the following crimes [include the dates,
location/jurisdiction, circumstances and outcome]:
 I have not been convicted of, nor am I under pending indictment for, any crimes
 I authorize Montana Department of Justice, Criminal Records and Identification Services Section to
disseminate criminal history record information to St. Ignatius Schools.
____________________________________________________________________________

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27 June 12, 2018
Signature of Applicant Date
Appendix C
Updated 9/9/2013
PRIVACY ACT STATEMENT
Authority: The FBI’s acquisition, preservation, and exchange of fingerprints and associated
information is generally authorized under 28 U.S.C. 534. Depending on the nature of your
application, supplemental authorities include Federal statutes, State statutes pursuant to Pub. L. 92-
544, Presidential Executive Orders, and federal. Providing your fingerprints and associated
information is voluntary; however, failure to do so may affect completion or approval of your
application.
Social Security Account Number (SSAN). Your SSAN is needed to keep records accurate because
other people may have the same name and birth date. Pursuant to the Federal Privacy Act of 1974 (5
USC 552a), the requesting agency is responsible for informing you whether disclosure is mandatory
or voluntary, by what statutory or other authority your SSAN is solicited, and what uses will be made
of it. Executive Order 9397 also asks Federal agencies to use this number to help identify individuals
in agency records.
Principal Purpose: Certain determinations, such as employment, licensing, and security clearances,
may be predicated on fingerprint-based background checks. Your fingerprints and associated
information/biometrics may be provided to the employing, investigating, or otherwise responsible
agency, and/or the FBI for the purpose of comparing your fingerprints to other fingerprints in the
FBI’s Next Generation Identification (NGI) system or its successor systems (including civil,
criminal, and latent fingerprint repositories) or other available records of the employing,
investigating, or otherwise responsible agency. The FBI may retain your fingerprints and associated
information/biometrics in NGI after the completion of this application and, while retained, your
fingerprints may continue to be compared against other fingerprints submitted to or retained by NGI.
Routine Uses: During the processing of this application and for as long thereafter as your
fingerprints and associated information/biometrics are retained in NGI, your information may be
disclosed pursuant to your consent, and may be disclosed without your consent as permitted by the
Privacy Act of 1974 and all applicable Routine Uses as may be published at any time in the Federal
Register, including the Routine Uses for the NGI system and the FBI’s Blanket Routine Uses.
Routine uses include, but are not limited to, disclosures to: employing, governmental or authorized
non-governmental agencies responsible for employment, contracting licensing, security clearances,
and other suitability determinations; local, state, tribal, or federal law enforcement agencies; criminal
justice agencies; and agencies responsible for national security or public safety.
Additional Information: The requesting agency and/or the agency conducting the application-
investigation will provide you additional information pertinent to the specific circumstances of this
application, which may include identification of other authorities, purposes, uses, and consequences
of not providing requested information. In addition, any such agency in the Federal Executive Branch
has also published notice in the Federal Register describing any systems(s) of records in which that
agency may also maintain your records, including the authorities, purposes, and routine uses for the
system(s).

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