THE CHURCH TEAM YOU SELECTED REQUIRES A BACKGROUND
CHECK PROVIDING INCREASED SECURITY BECAUSE OF THE ACCESS A TEAM MEMBER WILL
STEWARD IN THIS VOLUNTEER ROLE. PLEASE KNOW THIS INFORMATION IS KEPT
PRIVATE FOR THE USE OF COMPLETING A SECURE BACKGROUND CHECK AND THEN
PERMANENTLY REMOVED FROM OUR SYSTEM.
BY MY ELECTRONIC SIGNATURE BELOW, I CERTIFY THAT
THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUE AND COMPLETE WITH NO
OMISSIONS AND NOT MISLEADING IN ANY WAY. SHOULD MY APPLICATION BE ACCEPTED, I
AGREE TO SUBMIT TO THE POLICIES AND PROCEDURES OF CELEBRATION CHURCH AND TO
REFRAIN FROM UNSCRIPTURAL CONDUCT IN THE PERFORMANCE OF MY SERVICE ON BEHALF OF
CELEBRATION CHURCH. MY ELECTRONIC SIGNATURE ALSO DENOTES AGREEMENT TO THE
BACKGROUND CHECK THIS VOLUNTEER ROLE REQUIRES
DISCLOSURE AND AUTHORIZATION – BACKGROUND
INVESTIGATION
IN CONNECTION WITH MY APPLICATION FOR EMPLOYMENT OR TO SERVE AS A VOLUNTEER
WITH CELEBRATION CHURCH (“CLIENT’), I UNDERSTAND THAT A “CONSUMER REPORT”
AND/OR “INVESTIGATIVE CONSUMER REPORT”, AS DEFINED BY THE FAIR CREDIT REPORTING
ACT (15 U.S.C. § 1681), WILL BE REQUESTED BY CLIENT FOR EMPLOYMENT OR VOLUNTEER
PURPOSES, WHICHEVER IS APPLICABLE, FROM PROTECT MY MINISTRY, INC., (“PROTECT MY
MINISTRY”), A CONSUMER REPORTING AGENCY AS DEFINED BY THE FAIR CREDIT REPORTING
ACT. THESE REPORTS MAY INCLUDE INFORMATION AS TO MY CHARACTER, GENERAL
REPUTATION, PERSONAL CHARACTERISTICS OR MODE OF LIVING, WHICHEVER ARE
APPLICABLE. THEY MAY INVOLVE INTERVIEWS WITH SOURCES SUCH AS MY NEIGHBORS,
FRIENDS, OR ASSOCIATES. THE REPORT MAY ALSO CONTAIN INFORMATION ABOUT ME
RELATING TO MY CRIMINAL HISTORY, CREDIT HISTORY, DRIVING AND/OR MOTOR VEHICLE
RECORDS, SOCIAL SECURITY NUMBER VERIFICATION, VERIFICATION OF EDUCATION OR
EMPLOYMENT HISTORY, WORKER’S COMPENSATION (ONLY AFTER A CONDITIONAL JOB OFFER)
OR OTHER BACKGROUND CHECKS. SUCH REPORTS MAY BE OBTAINED AT ANY TIME AFTER
RECEIPT OF THIS DISCLOSURE AND AUTHORIZATION AND IF I AM HIRED OR SERVE AS A
VOLUNTEER, WHICHEVER IS APPLICABLE, THROUGHOUT THE COURSE OF MY EMPLOYMENT OR
VOLUNTEER SERVICE, AS PERMITTED BY LAW AND UNLESS REVOKED BY ME IN
WRITING. THE CLIENT RESERVES THE RIGHT TO REJECT ANY APPLICANT REGARDLESS
OF THE FINDINGS OF THE REPORT. CLIENT ALSO RESERVES THE RIGHT TO SHARE MY
REPORT WITH ANY THIRD-PARTY WITH WHOM I WILL BE PLACED TO WORK OR VOLUNTEER
WITH AS A REPRESENTATIVE OF CLIENT. I UNDERSTAND THAT I HAVE THE RIGHT, UPON
WRITTEN REQUEST MADE WITHIN A REASONABLE AMOUNT OF TIME AFTER THE RECEIPT OF
THIS NOTICE, TO REQUEST DISCLOSURE OF THE NATURE AND SCOPE OF ANY INVESTIGATIVE
CONSUMER REPORT TO PROTECT MY MINISTRY, INC., 14499 N. DALE MABRY HWY., SUITE
201 SOUTH, TAMPA, FL 33618 OR 1-800-319-5581. FOR INFORMATION ABOUT PROTECT MY
MINISTRY’S PRIVACY PRACTICES, SEE WWW.PROTECTMYMINISTRY.COM.
ACKNOWLEDGEMENT AND AUTHORIZATION.
BY SIGNING THIS FORM, I AUTHORIZE CELEBRATION CHURCH OR ITS AUTHORIZED AGENTS
TO OBTAIN OR PREPARE CONSUMER REPORTS OR INVESTIGATIVE CONSUMER REPORTS ABOUT
ME. I ACKNOWLEDGE RECEIPT OF A COPY OF THE FEDERAL NOTICE ENTITLED A
SUMMARY OF YOUR RIGHTS UNDER THE FAIR CREDIT REPORTING ACT AND CERTIFY THAT I HAVE READ THIS DISCLOSURE AND AUTHORIZATION
AS WELL AS THE SUMMARY DOCUMENT EXPLAINING MY RIGHTS UNDER THE FAIR CREDIT
REPORTING ACT.