Background Check Release Form printable pdf download

Background Check Release Form

Name_____________________

Date____________________

PLEASE READ AND UNDERSTAND THIS STATEMENT BEFORE

SIGNING YOUR APPLICATION

The information I have provided is true, correct and complete. False, incomplete or

misrepresented information of any kind, will be sufficient cause for my application to be

rejected.

I authorize representatives of First Baptist Church to contact and obtain information

about me from references I provided, and any other party necessary to verify the

accuracy of information I disclosed in this application. To assist in the processing of my

Application, I waive all rights and claims I may otherwise have against First Baptist

Church and its representatives, for seeking, and using information to evaluate my

request and all other persons, corporations or organizations who provide information

for this purpose.

I hereby, authorize representatives of First Baptist Church of Cleveland or their

agent, to conduct a background check for the purpose of participation in a mission trip

to ___________________________. I understand this will include obtaining

information and /or copies of civil, criminal and driving records. I authorize the release

of such.

___________________________

Signed

___________________________

Date of Birth

___________________________

Social Security Number

Background Check Release Form