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Background Check Authorization

This document is a background investigation consent form for an individual applying for employment at a church. It authorizes the church to conduct a background check on the applicant, including criminal records and references. It releases the church from any liability regarding information obtained through the background check. The form also requests identifying information from the applicant such as full name, addresses, date of birth, and social security number to conduct the background check.

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170 views1 page

Background Check Authorization

This document is a background investigation consent form for an individual applying for employment at a church. It authorizes the church to conduct a background check on the applicant, including criminal records and references. It releases the church from any liability regarding information obtained through the background check. The form also requests identifying information from the applicant such as full name, addresses, date of birth, and social security number to conduct the background check.

Uploaded by

vrydnn
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Background Investigation Consent Form

I, ________________________________, hereby authorize <CHURCH NAME> and/or its agents to


make an independent investigation of my background, references, character, past employment,
education, credit history, criminal or police records, including those maintained by both public and private
organizations and all public records for the purpose of confirming the information contained on my
application for employment and/or obtaining other information which may be material to my qualifications
for employment now and, if applicable, during the tenure of my employment with <CHURCH NAME>.

I release <CHURCH NAME> and/or its agents and any person or entity which provides information
pursuant to this authorization, from any and all liabilities, claims or law suits in regards to the information
obtained from any and all of the above referenced sources used.

The following is my true and complete legal name and all information is true and correct to the best of my
knowledge:

Full Name (Printed) _________________________________________________________

Maiden Name or Other Names Used ___________________________________________

Present Address ___________________________________________________________

City ____________________________________State__________Zip_________________

How Long at Present Address?________________________________________________

Former Address____________________________________________________________

City______________________________________State__________Zip_______________

How Long at Former Address?________________________________________________

Date of Birth*: _____________________________________________________________

Social Security Number: _____________________________________________________

Driver's License Number: _________________________ State of License: _____________

_________________________________________________________________________
Signature Date

*NOTE: The above information is required for identification purposes only and is in no manner used as a
qualification for employment. <CHURCH NAME> abides by all applicable state and federal employment
laws.

(06.07) This material is for informational purposes only. It is not intended to give specific legal or risk management advice, nor are
any suggested checklists or actions plans intended to include or address all possible risk management exposures or solutions. You
are encouraged to retain your own expert consultants and legal advisors in order to develop a risk management plan specific to your
own activities. For more information, contact the GuideOne Center for Risk Management at (877) 448-4331, ext. 5118 for Church
and Schools, or ext. 5175 for Senior Living Communities.
http://www.guideonecenter.com

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