APPLICANT’S AUTHORIZATION FOR RELEASE OF INFORMATION
I hereby
authorize Spokane Youth Sports Association, its
employees, agents, professional investigators, or any representative of the
above named company, to perform investigations into my background, past
behavior, character, and reputation.
Investigative reports may include criminal history
or arrest records, workers’ compensation histories, motor vehicle records,
employment and unemployment records, military records, or other sources of
information.
I authorize custodians of the records of any agency
or company as described herein to release such information upon request of any
investigator, agent, or representative of the Company named above. I understand
that any or all of these investigations or inquiries can be performed prior to
and periodically throughout the duration of my employment.
EDUCATION
– I authorize schools, colleges and all scholastic institutions to release any
and all information requested. This includes transcripts, grades, attendance
records, and any other information requested.
EMPLOYMENT – I authorize all former and current employers to release any and
all information regarding my employment history. This includes all information
contained in my personnel file, salary history, condemnations, and all other
pertinent information. I further authorize my supervisors and other work
associates to disclose their opinions and observations of my work habits,
qualities, competency, and skills. Furthermore, I authorize full disclosure of
any and all substance abuse testing results.
I understand that the
information requested is for the use by Spokane Youth Sports Association and may
be re-disclosed only as authorized by law. I understand that I have the right
to request from the Company a written disclosure of the nature and scope of the
investigation conducted that I authorized above if: (1) Any adverse
action/decision is made based on the information in the consumer report & (2) If
the request is made in writing within 60 days of the adverse action. If an
Investigative Consumer Report has been conducted, I will be notified in writing
within five days of receipt of my request for said report.
I believe
to the best of my knowledge that all information I have provided is accurate,
true, and correct and that I fully understand the terms of this release. I
indemnify, release and hold harmless SYSA, any agents of SYSA, or others
reporting to or for SYSA, any investigators, all former employers, reporting
agencies, and all those supplying references and character references, from any
and all claims, defamation, demands, and/or liabilities arising out of, or
related to, such investigators, disclosures, or admissions.
I have read
and understand this Consent and authorize SYSA and Pinnacle Investigations to
take such actions as are described herein: |
