Free background check form 06
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AUTHORIZATION & DISCLOSURE FOR BACKGROUND CHECK
I have read the Archdiocesan Policy on Background Checks and “A Summary of Your Rights Under the Fair Credit Reporting Act,”
understand my rights as outlined in that document and, in connection with my work with children or youth in the Archdiocese of New
York, authorize the agency where I am applying or currently serve in the Archdiocese, its affiliates, agents, and independent
contractors, to make the following background checks during the application/screening process and during the course of my
employment/service: criminal history, sex offender registration, and social security number verification.
Further, the information received in connection with this background checks is strictly confidential and will not be released except to
the personnel specified in the Archdiocesan Policy on Background Checks. Unless I so authorize in writing, the Archdiocese and its
independent contractors will not disclose or distribute the information gen