Permission Form to Run a Background Screening for Employment Purposes

In connection with your application for working at Hyde Park Baptist Church, we may procure a background report on you from Secure Search. In addition, we will check the Sex Offender’s Registry to confirm appropriateness for working with children. In the event that information from any of these reports is utilized in whole or in part in making an adverse decision, we will provide you with a copy of the report and a description in writing of your rights under the federal Fair Credit Reporting Act.

The Fair Credit Reporting Act gives you specific rights in dealing with consumer reporting agencies. You will be given a summary of these rights together with this document.

By your signature below, you hereby authorize us to obtain the above reports about you in order to consider you for our ministry team.

Name:

First Name

Last Name

Maiden or other names used:

Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Social Security Number (xxx-xx-xxxx):

Driver's License Number and State:

Full Name as it appears on Driver's License:

Date of Birth:

Note: Date of Birth information is used ONLY for verification of identity and is not used for any decision-making purposes by the Church.

MM

DD

YYYY

Digital Signature:

Typing your name in this box and clicking "Submit" below is the same as handwritten signatures for the purposes of validity, enforceability, and admissibility.