You're With Us! Background Check

This information allows Us! to run a Cori report and generate a fingerprint letter for each mentor and support individual for You're With Us! individuals. These background requirements are set by the state and allow us to run our unique, impactful program here in Massachusetts. Thanks for supporting our individuals and helping them create new social connections and experience a sense of belonging.

Name

First Name

Last Name

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of birth

YYYY

Last 6 numbers of Social Security Number