I hereby authorize AnB Education™ to request and receive any and all background information about or concerning me, including, my criminal history, felony and misdemeanor records, sex-offender records, inmate records and arrest information and child abuse history. I understand that this information will be used to determine to be a local coordinator with AnB Education™. This request is for criminal history and child abuse history only. No credit report will be requested or obtained.
I agree to indemnify and hold harmless the person to whom this request is presented and his/her agents and employees, from and against all claims, damages, losses and expenses, including reasonable attorneys fee, arising out of or by reason of complying with this request.
A photocopy of this release form will be valid as an original hereof, even though said photocopy does not contain an original writing of my signature. This authorization shall continue in effect until revoked by me writing.
By checking 'I agree' below I authorize ClearStar Background Check and its agents to obtain a Consumer/Investigative Consumer Report on me as part of its pre-employment background investigation process for employment purposes. I understand that this report may include, but is not limited to records containing criminal, credit and driving history information, drug testing, work history and verification of academic and or professional credentials. If I am offered employment, I further authorize my employer to obtain additional consumer/investigative consumer reports on me for employment purposes at any time during my employment. I hereby release and discharge CSL, its affiliates, and its agents from any liabilities, expenses, losses, damages for this investigative process to include the accuracy or timeliness of information obtained from other sources.
I also acknowledge that my potential employer has provided me (i) a clear and conspicuous Disclosure advising me that a background check/investigative background check may be obtained on me for employment screening purposes and I have provided them my written authorization to obtain the report(s) and (ii) a summary of my rights under the federal Fair Credit Reporting Act and any applicable state statutes.
I certify that the information provided is true and complete. Any false statement on this form, the application, and/or on my resume shall be considered sufficient cause for termination at any time.