BACKGROUND CHECK AUTHORIZATION. You hereby that you are the owner or relevant manager of the company you represent and authorize Angie's List to provide your home mailing address, social security number, date of birth ("Personal Information") and any other information you provide to us to a third-party information collection service entity selected by Angie's List, at any time while you are participating in the Advertising Program and/or Deals Program, to verify, obtain copies of records, and gather any information pertaining to your criminal record, as well as financial screening (including but not limited to searches for bankruptcies, liens and civil judgments) for the purpose of Angie's List's evaluating its desire to enter into or continue a contractual business arrangement with you. Angie's List will not share this Personal Information with any other third parties not designated for this purpose.
BACKGROUND CHECK AUTHORIZATION. I have never been convicted of any crime. If we find that this is untrue you will be terminated immediately. Please fill in the following as it gives A.B.M.C. authorization to run a background check. Social security number INS Number (if applicable) Date of Birth Place of Birth Signature
BACKGROUND CHECK AUTHORIZATION. You hereby: (a) represent that you are the owner of the company or a manager with authority to bind the company; and (b) authorize Xxxxx's List to provide your home mailing address, social security number, date of birth ("Personal Information") and any other information you provide to us to a third-party information collection service entity selected by Xxxxx's List, at any time while you are participating in the Advertising Program and/or Deals Program, to verify, obtain copies of records, and gather any information pertaining to your criminal record, as well as financial screening (including but not limited to searches for bankruptcies, liens and civil judgments) for the purpose of Xxxxx's List's evaluating its desire to enter into or continue a contractual business arrangement with you. Xxxxx's List will share this Personal Information only with third parties designated to carry out the background checks and with Xxxxx’s List’s affiliates.
BACKGROUND CHECK AUTHORIZATION. The information contained in this application is correct to the best of my knowledge. I hereby authorize SEBTS and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report to be generated for employment and/or volunteer purposes. I understand that the scope of the consumer report/ investigative consumer report may include, but is not limited to the following areas: verification of social security number; credit reports, current and previous residences; employment history, education background, character references; drug testing, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions; driving records, birth records, and any other public records. I further authorize any individual, company, firm, corporation, or public agency (including the Social Security Administration and law enforcement agencies) to divulge any and all information, verbal or written, pertaining to me, to SEBTS or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation, or public agency may have, to include information or data received from other sources. **SEBTS and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicants personal information, including, but not limited to, addresses, social security numbers, and dates of birth. Signature: _________________________________________________ Date: ________________________ FINANCIAL LIABILITY AGREEMENT I, , agree to be responsible for $3,000.00, which is my portion of the costs of the Nepal mission trip. I am attempting to raise support for this trip through family, churches and friends. However, I will personally be responsible for any shortage of these funds. If I am unable to raise the total amount due of $3,000.00, I will reimburse SEBTS for expenditures on my behalf. Student Signature: Date: SEBTS Representative Signature: Date: Indemnity Agreement and Release In consideration of my participation with the mission trip to S. Asia with Southeastern Baptist Theological Seminary during the dates of May 17-29, 2014, I, , a participant with Southeastern Baptist Theological Seminary academic project do hereby release, discharge and covenant to hold harmless Southeastern Baptist Theological...
BACKGROUND CHECK AUTHORIZATION. You hereby authorize Angie's List to provide your home mailing address, social security number, date of birth ("Personal Information") and any other information you provide to us to a third-party information collection service entity selected by Angie's List, at any time while you are participating in the Advertising Program and/or Deals Program, to verify, obtain copies of records, and gather any information pertaining to your criminal record, as well as financial screening (including but not limited to searches for bankruptcies, liens and civil judgments) for the purpose of Angie's List's evaluating its desire to enter into or continue a contractual business arrangement with you. Angie's List will not share this Personal Information with any other third parties not designated for this purpose.
BACKGROUND CHECK AUTHORIZATION. You hereby: (a) represent that you are the owner of the company or a manager with authority to bind the company; and (b) authorize Angie's List to provide your home mailing address, social security number, date of birth ("Personal Information") and any other information you provide to us to a third-party information collection service entity selected by Angie's List, at any time while you are participating in the Advertising Program and/or Deals Program, to verify, obtain copies of records, and gather any information pertaining to your criminal record, as well as financial screening (including but not limited to searches for bankruptcies, liens and civil judgments) for the purpose of Angie's List's evaluating its desire to enter into or continue a contractual business arrangement with you. Angie's List will share this Personal Information only with third parties designated to carry out the background checks and with Angie’s List’s affiliates.
BACKGROUND CHECK AUTHORIZATION. PROOF OF IDENTITY To the extent permitted by law, I authorize and give consent for Commonpoint Queens and its affiliates to perform a criminal background check, a sex offender registry check, and/or a driver’s license check, at the discretion of Commonpoint Queens until I revoke this consent or terminate my volunteering in writing, or until Commonpoint Queens terminates my volunteering in writing. I understand and agree that it is up to the discretion of Commonpoint Queens whether to accept me as a Volunteer and whether and when to terminate my volunteer status. I agree to provide a valid state driver’s license (or a valid passport or other photo ID if I do not drive), and two (2) references as part of this application.
BACKGROUND CHECK AUTHORIZATION. You hereby that you are the owner or relevant manager of the company you represent and authorize Xxxxx's List to provide your home mailing address, social security number, date of birth ("Personal Information") and any other information you provide to us to a third-party information collection service entity selected by Xxxxx's List, at any time while you are participating in the Advertising Program and/or Deals Program, to verify, obtain copies of records, and gather any information pertaining to your criminal record, as well as financial screening (including but not limited to searches for bankruptcies, liens and civil judgments) for the purpose of Xxxxx's List's evaluating its desire to enter into or continue a contractual business arrangement with you. Xxxxx's List will not share this Personal Information with any other third parties not designated for this purpose.
