CORI Request form

CORI Request form

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53 Lincoln Street Spencer MA 01562
(508) 885-3338

CORI Request Form

AWT Family LLC is requesting all the available criminal offender record information on the following individual from the Criminal History Systems Board pursuant to Chapter 6 §172C that mandates agencies which employ or accept as a volunteer or refer for employment any individual who will provide care, treatment, education, training, transportation, delivery of meals, instruction, counseling, supervision, recreation, or other services in a home or in a community based setting for any elderly person or disabled person who will have any direct or indirect contact with such elderly or disabled persons who access to such person’s files shall obtain all available CORI from the Criminal History Systems Board prior to employing such individual, accepting such individual as a volunteer or referring such individual for employment.
Applicant/Employee Information

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