Background Check

In order to volunteer for Vacation Bible School, the First Presbyterian Church of Corning must have a background check on file for you.
Please fill out the following form so that we might complete the check.

Background Check Authorization

* Indicates required field

Name (First, Middle, Last) *

Former Name(s) and Dates Used *

Current Address *

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City

State

Zip Code

Country

Current Address Since: *

Previous Address *

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Line 2

City

State

Zip Code

Country

Previous Address From: *

Previous Address *

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City

State

Zip Code

Country

Previous Address From: *

Social Security Number *

Date of Birth (MM/DD/YYYY) *

Phone Number *

Email *

Driver's License Number *

Driver's License State *

Gender *

Ethnicity *

The information contained in this form is correct to the best of my knowledge. I hereby authorize First Presbyterian Church of Corning and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report to be generated for employment and/or volunteer purposes. I understand that the scope of the consumer report/investigative consumer report may include, but is not limited to the following areas: verification of social security number; current and previous residences; employment history, education background, character references; drug testing, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions; driving records, birth records, and any other public records.

I further authorize any individual, company, firm, corporation or public agency (including the Social Security Administration and law enforcement agencies) to divulge any and all information, verbal or written, pertaining to me, to First Presbyterian Church of Corning or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation, or public agency may have, to include information or data received from other sources.

I hereby release First Presbyterian Church of Corning, the Social Security Administration, and its agents, officials, representative, or assigned agencies, including officers, employees, or related personnel both individually and collectively, from any and all liability for damages of whatever kind, which may, at any time, result to me, my heirs, family, or associates because of compliance with this authorization and request to release.

My signature to this form is signified by typing my full name and the date below and hitting submit.

Authorizing Signature *

Today's Date *

Submit

VBS Volunteer

Background Check Authorization