Background Check Authorization
All paid and some volunteer positions at the Church require a background check prior to service.
Email *
First, Middle, and Last Name *
Former Name(s) & Dates Used
Current Address & Dates of Residency *
Previous Address & Dates of Residency
Social Security Number *
Date of Birth *
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Phone Number *
Drivers License Number & State of Issuance *
The information contained in this background check authorization is correct to the best of my knowledge.
I hereby authorize Cornerstone Community Church DBA theStone 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 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 to divulge any and all information, verbal or written, pertaining to me, to Cornerstone Community Church DBA theStone 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. Cornerstone Community Church DBA theStone 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 (By typing your name, you are signing this authorization electronically. You agree your electronic signature is the legal equivalent of your manual signature on this authorization.) *
Date of Signature *
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