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Criminal Background Check Authorization

  1. Authorization for Release of Information

    I have applied for a volunteer position with the City of Burnsville. As part of the evaluation of my suitability for volunteering in this position, a background investigation is to be conducted. I authorize the Burnsville Police Department to conduct the background check in the following areas: Criminal History Check, Local Police Record Check, Warrant Checks, Driver’s License Check, and Historical Address Check.

  2. Contact Information

  3. By checking "Yes," I agree to allow the Burnsville Police Department to run a Criminal Background Check on me for the purposes of determining my suitability for this program. I hereby acknowledge that I have completed the above information fully and accurately.*


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  5. This field is not part of the form submission.