Fillable Ymca Of Metropolitan Los Angeles Application Form For Employment (Page 6 of 8) in pdf

NOTICE AND CONSENT CONCERNING CONSUMER AND

INVESTIGATIVE CONSUMER REPORTS

This form, which you should read carefully, has been provided to you because the YMCA of Metropolitan Los

Angeles ("Association") may request consumer reports or investigative consumer reports in connection with your

application for employment or during the course of your employment with the Association, if any, or for other

employment-related purposes.

The types of reports that may be requested from consumer reporting agencies under this policy include, but are not

limited to, credit reports, criminal records checks, court records checks, driving records, and/or summaries of

educational and employment records and histories. If applying for a position where you may supervise, discipline,

or care for minors, this information may include all criminal and arrest records allowed under California Penal Code §

11105.3, and that you may be required to submit fingerprints in a manner required by the Association. The infor-

mation contained in these reports may be obtained by a consumer reporting agency from public record sources or

through personal interviews with your coworkers, neighbors, friends, associates, current or former employers, or

other personal acquaintances. Any information contained in such reports may be taken into consideration in evalu-

ating your suitability for employment, promotion, reassignment or retention as an employee.

CONSENT STATEMENT

I have carefully read and understand this notice and consent form and confirm that all such information is true

and correct. By my signature below, I consent to the release of consumer or investigative consumer reports, as

defined above, to the Association (1) in conjunction with my application for employment, and (2) during the

course of my employment, if any. I further understand that this consent will apply during the course of my employ-

ment with the Association, should I obtain such employment. I understand and agree that this consent will remain

in effect indefinitely. I further understand that any and all information contained in my job application or otherwise

disclosed to the Association by me may be utilized for the purpose of obtaining the consumer reports or investi-

gative consumer reports requested by the Association. I understand and acknowledge that nothing in this Notice

and Consent is intended to be, or is, an offer of employment or a promise of continued employment. If employed

by the Association, my employment will not be for a specified period of time and can be terminated at any time, for

any reason, with or without cause or notice, by me or by the Association.

By placing a check here

I am requesting that I be furnished with a copy of any consumer report that is obtained

or used in connection with my application for employment.

__________________________________________

Name (Please Print)

Social Security Number

_______________________________________________________________

Signature

Date

Ymca Of Metropolitan Los Angeles Application Form For Employment Page 6