Volunteer Background Check Form

 

CONFIDEnTIAL- DISCLOSURE and AUTHORIZATION – BACKGROUND INVESTIGATION

In connection with serving as a volunteer with South Elm Street Baptist Church (“Client’), I understand that a “basic investigative consumer report”, will be requested by Client for volunteer purposes from Protect My Ministry, Inc., (“Protect My Ministry”), a consumer reporting agency as defined by the Fair Credit Reporting Act.  This is NOT a credit check of any type. These reports may include information as to my character, general reputation, personal characteristics or mode of living, whichever are applicable. The report may also contain information about me relating to my criminal history, driving and/or motor vehicle records or other background checks. Such reports may be obtained at any time after receipt of this Disclosure and Authorization throughout the course of my volunteer service, as permitted by law and unless revoked by me in writing.  I understand that I have the right, upon written request made within a reasonable amount 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 below, I voluntarily and knowingly authorize Client or its authorized agents to obtain or prepare a basic investigative consumer report about me.  I acknowledge that I have read this Disclosure and Authorization as well as the summary explaining my rights under the Fair Credit Reporting Act.