Release of Information Form

All co-opers, whether new or returning, must complete and submit this form annually.

We will also use the information in this form to determine if additional out-of-state background checks will be required. If so, we will contact you directly about what you will need to do.

Before submitting, please double check for these common errors:

1. Did you complete both pages of this form?

2. Are all fields filled out completely and accurately?

3. Write “Aide” under “Position”

4. Did you fill out your “Primary Language”?

5. Did you select your race and ethnicity?

Important: DO NOT sign, date or notarize this form before uploading onto Jovial. You will sign up to have it notarized (for free) with Robin Webster at the Big Clean or the Caregiver and Co-Oper Orientation events.