Background Check Forms - Waltham Boys And Girls Club

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WALTHAM BOYS & GIRLS CLUB
CONSENT TO PROCURE BACKGROUND REPORT
During the application process and at any time during the tenure of my employment
service with the WALTHAM BOYS & GIRLS CLUB, I hereby authorize First Advantage
Inc, on behalf of the WALTHAM BOYS & GIRLS CLUB to procure a consumer report
(which I understand may include information regarding my character, general reputation
or personal characteristic. This report may be compiled with information from courts
record repositories, departments of motor vehicles, past or present employers and
educational institutions, governmental occupational licensing or registration entities,
business or personal references, and any other source required to bearing information
that I have voluntarily supplied. I understand that I may request a complete and
accurate disclosure of the nature and scope of the background verification, to the extent
such investigations includes information bearing on my character, general reputation or
personal characteristics.
_______________________
____________________
Applicant signature
Date
_____-_________-__________
_____________________
Social Security Number*
DOB *
*For identification purposes only
Printed Name __________________________________________________
Street Address __________________________________________________
City, State, Zip ______________________________________________________________
Phone ____________________________________________________________

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