DISCLOSURE
FOR BACKGROUND CHECK
Big Brothers Big Sisters of Northwestern Wisconsin will procure an investigative
consumer report (as defined under
the Fair Credit Reporting Act) on you in connection with your application for engagement as a volunteer. These background reports may be obtained
at any time
after receipt of your authorization and, if you are hired or engaged
by the BBBSNW, throughout your
employment, engagement or contract
period.
AUTHORIZATION
By my
signature below, I consent
to
the preparation of background reports, and to the release of such reports
to the BBBSNW and its designated representatives
for the purpose of assisting
the BBBSNW in making
a determination as to my eligibility
for
employment, promotion, retention, engagement as a volunteer or independent contractor, or for other lawful purposes.
I understand that, to the extent allowed by law, information contained in my job or volunteer
application, or otherwise
disclosed to the
BBBSNW by me before or during my employment, while volunteering or contracting, if any, may be utilized for the purpose of obtaining such consumer reports and/or
investigative consumer reports
about me. I understand that nothing herein shall be
construed as an offer of employment, service as a volunteer or offer to engage an independent contractor.
I hereby authorize law enforcement agencies, learning institutions (including public and private schools and universities), information service bureaus, credit bureaus, record/data repositories, courts (federal/state/local), motor vehicle record agencies, my past or present employers, the military,
and other individuals or sources
to furnish any and all information on me that is requested by the consumer
reporting agency.
By my signature (including electronic) below, I certify
the information provided
on and in connection with this form is true, accurate,
and complete. I agree that this form in original, faxed, photocopied or electronic form will be valid for any background reports that may be requested
by or on behalf of the BBBSNW.
This information
is being collected to conduct
the background screen on
you. It will not be
used for any other purpose.