Gender
Select… Male Female
Do you have children?
Select… Yes No
Have you completed Growth Track?
In what area are you interested in serving?
What date do you want to start? *
Have you been arrested for a criminal offense?
Select… Yes No
Have you been accused of any sexual misconduct?
Select… Yes No
Background Screening - Signature required in the box below *
I understand that a consumer report (background screening report) and/or an investigative consumer report (reference checks and/or interview) that may include information from public or private sources regarding my character, driving records, criminal history, court records (both civil and criminal), qualifications and experience, work habits, and/or other information relevant to my volunteer service may be obtained in connection with my application as a volunteer with TrinityLife. I understand that, if I am approved for volunteer service by TrinityLife, this background check authorization will be kept on file and may be used at any time during my service to procure further information when, in the judgement of TrinityLife, such may be necessary. I hereby release and discharge to the extent permitted by law, TrinityLife, its employees, any individual or agency obtaining information for TrinityLife, and any personal or professional reference, from any and all claims, damages, losses, liabilities, costs, or other expenses arising from the retrieving, reporting, and/or disclosure of information in connection with this background investigation. I understand that I am volunteering my services and declare in no way shall I be considered an employee, subcontractor or independent contractor of TrinityLife. By signing below, I have read and understand and consent to the above. I further authorize that a photographic copy of this document shall be valid for purposes present and future. My electronic signature below certifies that all information I have provided in connection with this background check is true, accurate, and complete to the best of my knowledge. I understand that I have specific prescribed rights as a consumer under the Fair Credit Reporting Act and may have additional rights under relevant state laws. I hereby certify that I have read the Summary of Rights under the Fair Credit Reporting Act located at http://www.safehiringsolutions.com/pdfs/FCRAsummary.pdf
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