MBC Background Check Application
Last Name *
First Name *
Middle Name *
Address *
City *
State *
Zip *
Email *
Birthdate *
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DD
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YYYY
Sex *
Race *
Authorization for Release
In connection with my application for ministry with MBC, I authorize MBC to solicit background information relative to my criminal record history. I understand that MBC may conduct inquiries into my background that may include criminal records, personal references and other public record reports pertaining to me.

I authorize without reservation, any person, agency, or other entity contacted by Metro Believers Church for purposes of obtaining background report information, to furnish the above mentioned information.

I release Metro Believers Church, their respective employees, and all persons, agencies, and entities providing information or reports about me from any and all liability arising out of furnishing any such information on reports.
Signature *
Date *
MM
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DD
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YYYY
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