Request for Electronic Police Check - Template

Request For Electronic-Police Information Check (E-PIC)

Note: Clubs will be required to modify this letter to adhere to any requirements from the E-PIC provider

INTRODUCTION

[insert Organization] is requesting an E-PIC for _____________ [insert individual’s full name] who identifies as a _____________ [insert gender identity] and who was born on ______________ [insert birthdate].

DESCRIPTION OF ORGANIZATION

[insert Organization] is a not-for-profit [national, provincial, local] organization for the sport of canoe kayak located in [location]. [Insert additional description]

DESCRIPTION OF ROLE

_____________ [insert individual’s name] will be acting as a _____________ [insert individual’s role]. In this role, the individual will have access to vulnerable individuals. [Insert additional information re: type and number of vulnerable individuals, frequency of access, etc.]

CONTACT INFORMATION

If more information is required from [insert Organization], please contact the Screening Committee Chair: [Insert information for Screening Committee Chair] Signed:

____________________________ Date: ____________________________

  • Government of Alberta
  • Coach Canada
  • La Farge
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