BACKGROUND CHECK AUTHORIZATION 

This is required for ALL trip applicants over age 13.

Minor applicants (under age 18) must sign and scan a downloaded hard copy with the signed permission of a legal guardian. Applicants over 18 may submit a hard copy OR submit the online form at the bottom of this page. 

All scanned copies may be emailed to selliott@gpartners.org.

PRINTABLE FORM

 

ONLINE FORM 

(FOR AGES 18 AND OLDER)

 

NOTICE, AUTHORIZATION AND RELEASE FOR THE PROCUREMENT OF AN INVESTIGATIVE CONSUMER REPORT


I, the undersigned consumer, do hereby authorize Global Partners in Peace and Development to obtain an investigative consumer report on me through reputable vendors. I understand that this authorization and release shall also be valid for any subsequent investigative consumer reports during the period of time I continue to be employed or volunteer with Global Partners in Peace and Development. The purpose of these investigative consumer reports is to discover any incidents of criminal activity or other misconduct in which I am alleged to have been involved.


These above-mentioned reports may include, but are not limited to, information as to my character, general reputation, and personal characteristics, discerned through a social security number trace; criminal and civil history/records; any other public record; and for prospective employees, employment and education verifications; personal references; personal interviews; my driving history, including any traffic citations; present and former addresses.


I understand that Global Partners in Peace and Development typically performs a National Criminal Database search; a Social Security search; a National Sexual Offenders Registry search; and a Virginia State Police Sex Offender and Crimes Against Minors Registry search, but could conduct other searches from time to time.


I further authorize any person, business entity or governmental agency who may have information relevant to the above to disclose the same to Global Partners in Peace and Development by and through its vendor, including, but not limited to any and all courts, public agencies, and law enforcement agencies, regardless of whether such person, business entity or governmental agency compiled the information itself or received it from other sources.


I understand that I am entitled to a complete and accurate disclosure of the nature and scope of any investigative consumer report of which I am the subject upon my written request to Global Partners in Peace and Development, if such is made within a reasonable time after the date hereof. I also understand that I may receive a written summary of my rights under 15 U.S.C. § 1681et. seq.

Please mark N/A in any box if necessary

+ This information will enable us to properly identify you in the event we find adverse information during the course of our background search.

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