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    Background Check Form

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    crabbygirl
    This document is an agreement for Lakewood Baptist Church to conduct a background check on an applicant. It authorizes the church to use a consumer reporting agency to research the applicant's personal and employment background, character, and qualifications. The applicant agrees to release any relevant information, including criminal, driving, education, employment, and personal reference records to the church. The applicant will be notified if the background check results in a denied application.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Background Check Form

    Uploaded by

    crabbygirl
    120 views1 page
    This document is an agreement for Lakewood Baptist Church to conduct a background check on an applicant. It authorizes the church to use a consumer reporting agency to research the applicant's personal and employment background, character, and qualifications. The applicant agrees to release any relevant information, including criminal, driving, education, employment, and personal reference records to the church. The applicant will be notified if the background check results in a denied application.

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    This document is an agreement for Lakewood Baptist Church to conduct a background check on an applicant. It authorizes the church to use a consumer reporting agency to research the applicant's personal and employment background, character, and qualifications. The applicant agrees to release any relevant information, including criminal, driving, education, employment, and personal reference records to the church. The applicant will be notified if the background check results in a denied application.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    120 views1 page

    Background Check Form

    Uploaded by

    crabbygirl
    This document is an agreement for Lakewood Baptist Church to conduct a background check on an applicant. It authorizes the church to use a consumer reporting agency to research the applicant's personal and employment background, character, and qualifications. The applicant agrees to release any relevant information, including criminal, driving, education, employment, and personal reference records to the church. The applicant will be notified if the background check results in a denied application.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
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    AGREEMENT, AUTHORIZATION, AND CONSENT FOR RELEASE OF BACKGROUND INFORMATION

    PLEASE TYPE OR PRINT

    I,
    LAST NAME FIRST NAME MIDDLE NAME (PLEASE INCLUDE Jr., Sr., II, III Etc.)

    understand that in conjunction with my application for employment, work to be performed under contract, promotion, volunteer position,
    reassignment, and/or retention (“Work”), Lakewood Baptist Church will use the services of an outside agency to research and verify
    the information I have provided on my application for employment including my personal background, character, professional standing,
    work history and qualifications. This agency will provide a written report of its findings to Lakewood Baptist Church. Lakewood
    Baptist Church uses a consumer-reporting agency, as an agent to perform its background investigations.

    We will utilize various sources of information it deems appropriate including but not limited to: criminal conviction records, current and
    former employers, department of motor vehicle records, military records, credit reporting agencies, education records, professional and
    personal references and workers compensation records including any and all injuries in compliance with the Americans with Disabilities
    Act. I agree, authorize and consent to the release and disclosure of any and all information including but not limited to the above to
    Lakewood Baptist Church.

    I agree, authorize and consent to the procurement of a Consumer Report and/or an Investigative Consumer Report and understand that
    it may contain information about my credit worthiness, credit standing, credit capacity, character, general reputation, personal
    characteristics, or mode of living. This authorization in original or copy form shall be valid for my term of Work from the date indicated
    next to my signature. According to the Fair Credit Reporting Act, I will be notified by Lakewood Baptist Church if Work is denied
    because of information obtained from a Consumer Reporting Agency. Additionally, I understand that if requested within 60 days, I will
    be given a full and accurate disclosure as to the nature and substance of all information provided to Lakewood Baptist Church. I
    further understand that I may request a copy of the report.

    CHECK THIS BOX IF you are applying for work with a California, Minnesota or Oklahoma based employer and you would like a
    copy of your Consumer Report if one is prepared in the investigation of your background. CA Codes 1785.20.5 & 1786.16(a)(5)(b)(1),
    MN Code 13C Subdivision 2, OK Code 24 O.S. §148

    L AW E N F O R C E M E N T A G E N C I E S A N D O T H E R E N T I T I E S F O R P O S I T I V E I D E N T I F I C AT I O N P U R P O S E S
    R E Q U I R E T H E F O L L O W I N G I N F O R M AT I O N W H E N C H E C K I N G P U B L I C R E C O R D S . I T I S C O N F I D E N T I AL
    AND WILL NOT BE USED FOR ANY OTHER PURPOSES. PLEASE PRINT CLEARLY.

    Signed Today’s Date

    Name as it appears on your driver’s license Position Applied For

    . - - . . / /
    Social Security Number Date of Birth Driver’s License Number State

    Other names you have used, or are also known as, including maiden name, name changes and any aliases:

    PLEASE PROVIDE ALL RESIDENTIAL ADDRESSES FOR THE PAST 7 YEARS


    Mo./Yr. / Mo./Yr

    Current Address: /
    Street Apt.# City State Zip Code From / To?

    Former Address: /
    Street Apt.# City State Zip Code From / To?

    Former Address: /
    Street Apt.# City State Zip Code From / To?

    Former Address: /
    Street Apt.# City State Zip Code From / To?

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