Child Welfare Record Check Request

If you require a Child Welfare Record Check for employment, please fill out the Child Welfare Record Check form.

You must attach one copy of valid government issued photo identification along with your request.

"*" indicates required fields

Personal Details

Name*

First Name Last Name

Alternate Name (e.g. maiden name, preferred name, alias)

Date of Birth*

Contact Information

Address*

Number and Street Name Unit Number City Select Province Postal Code Country

Phone Number*

Preferred Phone Number*

Home

Work

Cell

Email Address

Previous Places of Residence

I have lived in the following places since I reached the age of 18 years or became a parent, whichever first occurred:

City, Province, Country

Dates (from – to)

Additional Information

Searches may result in multiple records with similar names and dates of birth. The additional information provided below will be used only to assist in locating any child protection records pertaining to you.

My Child’s Name

Child’s Date of Birth (MM/DD/YYYY)

Child’s Mother’s Maiden Name

My Parent/Caregiver’s Name

Parent/Caregiver’s Date of Birth (MM/DD/YYYY)

Request Details

Request Description

If possible, please provide additional details regarding the reason for your request as this will assist us to provide you with the information you require.

Additional Information

Please attach information to support your request.

Additional Information File 1

Max. file size: 300 MB.

Additional Information File 2

Max. file size: 300 MB.

Additional Information File 3

Max. file size: 300 MB.

Additional Information File 4

Max. file size: 300 MB.

Confirmation & Consent*

I certify the above information to be accurate.

Confirmation & Consent Checkbox 2*

I consent to a search of the provincial Child Protection Information Network (CPIN) and of Children’s Aid Society of the Districts of Sudbury and Manitoulin’s legacy system in order for the Society to fulfil my request.

Confirmation & Consent Checkbox 3*

I agree that my submitted data is being collected and stored by the Children’s Aid Society of the Districts of Sudbury and Manitoulin. Please Note: The Children’s Aid Society of the Districts of Sudbury and Manitoulin must abide by the privacy rules set out in the Child, Youth and Family Services Act, 2017.