I authorize D.E.S.T.I.N.E.D. to Succeed, Inc. to investigate all statements in this application. I also authorize them to conduct a background check to include a criminal record check (if I am 18 or older) and reference check. I hereby acknowledge that I have read and understood the preceding statement. I understand that my picture/video may be taken for the media and/or public relations and allow these pictures to be used for media and/or public relations purposes unless I otherwise submit in writing to D2S. *
Signature & Date (Your printed electronic signature serves as your official signature):