Background Check Form Name * First Name Last Name Email * Phone (###) ### #### I agree to a background check * Yes, I understand and agree that backgroundchecks.com will verify all of part of the information I have given my prospective organization. I understand that this verification may include any inquiry into criminal and civil records, as well as other public record information. I authorize the release of such information as may be necessary to verify the information I have provided. I release and hold harmless from all liability any individual or entity requesting or supplying information with respect to my application for employment or volunteering at The Well Church Keller. Checking this box serves as your consent to an initial background check report from backgroundchecks.com, and periodic background checks as long as you are an active volunteer with Children at The Well. You certify that the information you provided is correct and you agree with the applicant consent listed above. No Social Security Number *Secured * Driver's License Number *Secured * Date of Birth MM DD YYYY Thank you!
