Hospital Hospitality House of Nashville Guest Applicant Background Check Authorization
As part of the Guest Application process for Hospital Hospitality House of Nashville (HHH), I understand that HHH may hire Selection.com to obtain “Consumer Reports” about me as defined in the Fair Credit Reporting Act (FCRA). These “Consumer Reports” may include all of my criminal his-tory. I understand that HHH may rely on any or all of the above-referenced information to determine my eligibility for temporary residency. If HHH considers making an adverse, residency-related decision that will affect me based, in whole or in part, upon a “Consumer Report” obtained from Selection.com, I will be offered a copy of the “Consumer Report” and a written summary of my “Consumer Rights” under the FCRA before HHH finalizes that decision. I have read the above disclosure and I hereby authorize Hospital Hospitality House of Nashville, TN, Inc., and Selection.com or its authorized agents to obtain the above-referenced information about me. I also authorize all agencies, bureaus, employers, information service organizations and individuals to provide any of the above-referenced knowledge or information they have concerning me. Furthermore, this authorization shall remain on file and shall serve as an ongoing authorization for HHH to obtain “Consumer Reports” about me from SMS at any time during my temporary residency at HHH. A photocopy or facsimile of this authorization shall be as valid as the original.

Please note: this form must be completed for EVERY individual who intends to stay overnight at HHH.

***Please read the paragraph above and enter your name below. By entering my name in the space below, I understand that I am submitting my signature electronically, acknowledging agreement of the above statement. *
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms