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Applicants for employment or persons hired by the Spring Hill Recreation Commission, (hereafter employing entity) or other affiliated organizations may be asked to complete this form. A checkbox by a report category indicates that this type of report may be requested, and your authorization is requested. Background checks are obtained by the Spring Hill Recreation Commission from a commercial provider.
I request, authorize, and consent to the release of a credit report and/or investigative consumer report concerning me by any credit reporting agency. I understand that I can obtain the address and telephone number for the selected credit reporting agency(ies) from the Spring Hill Recreation Commission.
I understand that the results of a background check and my credit records will be used as part of the evaluation of my application and that both verbal and written reports may be obtained. I also understand that an investigative consumer report concerning me may include information about my character, general reputation, personal characteristics, and mode of living. I further understand that I am entitled to review any files containing such investigative consumer reports at the offices of the Spring Hill Recreation Commission during normal business hours. I may also receive copies of any such report by certified mail, if I make a written request addressed to the Spring Hill Recreation Commission. I also understand that, to protect my privacy, I cannot receive a verbal summary of such information by telephone. To receive any of this information or access to records, I realize that I must submit proper identification of my request. The employing entity will not deny employment or terminate employment solely on the basis that an applicant has filed bankruptcy. Please indicate if you would like to receive a copy of your credit report or investigative consumer report.
I request, authorize, and consent to the employing entity's thorough investigation of whether I have a record of criminal convictions and, if so, the nature of such criminal convictions and all surrounding circumstances available through lawful means. The employing entity has advised me that its criminal background check will focus on convictions and that a criminal record will not necessarily disqualify me from consideration for employment or cause termination of my employment.
I request, authorize, and consent to the release and disclosure to the employing entity of educational records from any and all public or private educational institutions that I have attended. Such educational records include all records of my academic performance, courses attended, grades earned, diplomas, degrees, or other certificates conferred. These records are to be released and disclosed to the employing entity in connection with a background check pertaining to an application for employment or for continued employment. My consent to the release and disclosure of these records applies only to the employing entity, its agents, servants, officers, or employees. This consent is given with the understanding that the employing entity will not transmit the information contained in these records to any other agency or person without my written consent.
I request, authorize, and consent to the release of information to the employing entity regarding my previous employment and authorize all past employers or agents that they may designate to respond to verbal or written inquiries from the employing entity regarding my employment record, including, but not limited to, positions held, dates of employment, last pay rate, work performance, disciplinary records, reliability, and any incidents of dishonesty, insubordination, violence, and/or unsafe, harmful, or threatening behavior, including information based upon materials in my personnel files.
I request, authorize, and consent to the release of information from any public agency or private entity concerning any professional or vocational license or certification that I have held in the past or currently hold, including, but not limited to, information concerning whether such license or certification is in good standing and any disciplinary or other proceedings concerning such license or certification.
I request, authorize, and consent to the employing entity's contacting the personal references identified in my application for purposes of confirming information contained in my application for employment and otherwise furthering the purposes of the employing entity's applicant background and employee investigation policy. I specifically authorize, request, and consent to the employing entity's verbal or written inquiries addressed to my personal references about the information contained in my application or other documents representing my application for employment, as well as my reliability honesty, and potential tendency, if any, to engage in any form of violence or other harmful, unsafe, or threatening behavior.
I authorize the Spring Hill Recreation Commission or its designate to perform the background checks I have authorized on the Background Checks Release form. I understand that any offer of coaching extended to me by the Spring Hill Recreation Commission is contingent upon a satisfactory check of my criminal background and any other background check I have authorized. I hereby release the Spring Hill Recreation Commission, its officers, agents, assigns, and heirs, and my current employer, my prior employers, and all personal references from any liability and damages incurred as a result of furnishing this information.
I further understand that I have a continued obligation to report any arrests or convictions for any charge other than minor traffic infractions. I understand and agree that the purpose of the criminal background check and this continuing obligation to report is to help to ensure a safe environment for Spring Hill Recreation Commission participants, volunteers, and employees.
A copy of this document with my signature shall have the same force as the original.
I have either reviewed this release with an attorney prior to executing or waived my right to do so.
This field is not part of the form submission.
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