For all programs through which our volunteers/employees will have access to children and the elderly, the Neighborhood Center must receive a completed CORI (Criminal Offender Record Information) Application. Please print this application (or copy into a Microsoft Word Document), fill out and send to the Neighborhood Center immediately. Address is listed at bottom of application. Thank you.
As of June 30, 2005, under new regulations enacted by the Legislature, the CORI form has been updated. The Boston College Neighborhood Center will now be verifying the applicant's identity with a government issued photographic form of identification. In addition, the Neighborhood Center must provide an applicant with an opportunity to challenge the accuracy and relevance of the CORI prior to making an adverse decision. Please click here to read the CORI Policy and Information Concerning the Process in Correcting a Criminal Record.
CHSB Codes:
BCNBC
172H
FE719
Boston College Neighborhood Center
425 Washington Street
Brighton, MA 02135
(617) 552-0445
The Boston College Neighborhood Center has been certified by the Criminal History Systems Board for access to conviction and pending criminal data. As an applicant for the position of volunteer, I understand that a record check will be conducted for conviction and pending criminal case information only and that it will not necessarily disqualify me as a candidate for the position. The information below is correct to the best of my knowledge.
Applicant's Information
Program you are volunteering/working for (please check):
Tutoring ___ Read Boston ___ Elderly ___ Strong Women, Strong Girls ____
Applicant Signature: ________________________________________________________
Last name: _______________________ First name: ________________________ MI. _____
Maiden name (if applicable): ________________________
Place of Birth:________________________
Date of Birth: _____________
Social Security # (Requested but not required):_______________________
ID Theft Index PIN (if applicable): _________________________________
Mother's Maiden Name: __________________________________
Current and Former Addresses: ___________________________________________________________________
___________________________________________________________________
Gender: _____ Height: ______ feet ______inches Weight: _______ Eye Color: ___________
State Driver's License Number & State:______________________________________
***You MUST send a copy of your driver's license OR passport when submitting the CORI form.***
PLEASE RETURN IMMEDIATELY TO THE BOSTON COLLEGE NEIGHBORHOOD CENTER
If on campus:
Please put in envelope and write Boston College Neighborhood Center and CAMPUS MAIL on the envelope and put in brown campus mailbox. NO postage necessary.
If mailing from off campus:
Please address stamped envelope to:
BOSTON COLLEGE NEIGHBORHOOD CENTER
425 WASHINGTON ST, BRIGHTON, MA 02135
BCNC Use Only
***The above information was verified by reviewing the following form of Government Issued Photographic Identification: _____________________________________________________
Requested By: ______________________________(Signature of CORI Authorized Employee)