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- Faculty and Staff
- Requests and Forms
- Central Registry Clearance Forms by State
Ohio
Click the button below to open the release form. Please read the form carefully and be sure to complete all fields as instructed in the form.
Print and mail the completed form with original signatures (in ink) to the address below. Interlochen will submit the form and any applicable fees to your state's clearance agency on your behalf. Please include a copy of your driver’s license and social security card.
Please note: The form must be notarized.
Interlochen Center for the Arts
Human Resources, Attn: DHHS
PO Box 199
Interlochen, MI 49643
**Once your state’s clearance agency processes the form, they will send the results back to you personally, not to Interlochen. When you receive the results, please mail the original documents to us at the address above. Failure to provide results may require us to cancel your summer contract.