I certify that all information I have provided in order to apply for and secure work with the employer is true, complete, and correct.
I expressly authorize, without reservation, the employer, its representatives, employees, or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities, and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, résumé, or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees, or representatives, for seeking, gathering, and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations, or organizations for furnishing such information about me.
I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state, or federal law.
I understand that this application remains current for only 60 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application.
If I am hired, I understand that I am free to resign at any time, with or without cause and with or without prior notice, and the employer reserves the same right to terminate my employment at any time, with or without cause and with or without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer's president.
I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.
I understand that reasonable safeguards will be taken to protect all personal information provided or obtained in conjunction with this application for employment. My personal information may be shared with the employer's affiliate(s) and third parties engaged by the employer to perform services for the employer. Any personal information shared with an affiliate or third party is to be used solely to perform the services requested by the employer.
This Company does not tolerate unlawful discrimination in its employment practices. No question on this application is used for the purpose of limiting or excluding an applicant from consideration for employment on the basis of his or her race, religion, color, sex (including pregnancy), age, national origin, disability, marital status, height, weight, genetic information, or any other protected status under applicable federal, state, or local law.
I understand that any information provided by me that is found to be false, incomplete, or misrepresented in any respect, will be sufficient cause to (i) eliminate me from further consideration for employment, or (ii) may result in my immediate discharge from the employer's service, whenever it is discovered.
Enter your name in the text box below to sign your application and agree to these terms.
Authorization: By signing below, you authorize: (a) backgroundchecks.com (“BGC”) to request information about you from any public or private information source; (b) anyone to provide information about you to BGC; (c) BGC to provide us (NTI Services, Corp.) one or more reports based on that information; and (d) us to share those reports with others for legitimate business purposes related to your employment. BGC may investigate your education, work history, professional licenses and credentials, ref-erences, address history, social security number validity, right to work, criminal record, lawsuits, driving record, credit history, and any other information with public or private information sources. You acknowledge that a fax, image, or copy of this authorization is as valid as the original. You make this au-thorization to be valid for as long as you are an applicant or employee with us.
The Consumer Financial Protection Bureau’s “Summary of Your Rights under the Fair Credit Reporting Act” is attached to this authorization. If you are a New York applicant, a copy of New York’s law on the use of criminal records is attached. By signing below, you acknowledge receipt of these documents.
Applicant is making and giving certain requests, directions, instructions, waivers, releases and authorizations for and to CrimShield in consideration for the performance of a background investigation and providing a copy of the investigative results to the Applicant and to the Applicant’s employer or prospective employer, all pursuant to this agreement. The Parties hereby enter into this agreement upon the covenants and conditions set forth herein.
Applicant hereby informs CrimShield that Applicant has a legitimate business need in connection with a business transaction for which Applicant is in need of CrimShield to perform a background investigation on Applicant and that Applicant is hereby making and providing this written request, instructions, directions and authorizations to CrimShield for CrimShield to perform a background investigation on Applicant in order for CrimShield to obtain whatever information CrimShield can discover about Applicant’s personal history from any and all sources CrimShield chooses to use in its investigation, including, but not limited to, researching my: criminal history; character; general reputation; history of payments; driving record; performing or having drug screenings performed on me and having drug testing reports prepared; credit bureau reports from any credit reporting agency; workman comp claims; social security number, addresses and date of birth verifications; social media information, judgments; public records; social records; private records, evictions, credit worthiness, financial scores, credit standing, credit capacity, general reputation, personal characteristics, mode of living and any other information whatsoever.
Applicant also requests, directs, instructs and authorizes CrimShield to send/share the results of Applicant’s background investigation to/with Applicant and with NTI Services, Corp. or GEM Communications, Corp. at 7045 Calumet Ave., Hammond, IN 46324.
Applicant understands that Applicant will have access to Applicant’s investigative report at CrimShield through an electronic portal where Applicant may view the investigative findings by CrimShield. Applicant understands that Applicant may dispute inaccurate or incomplete information in Applicant’s investigative report. Applicant understands and agrees that accurate information will not be changed. Applicant also acknowledges that the investigative findings of CrimShield are only valid as of the date of the CrimShield investigative report.
Applicant authorizes, directs, and instructs any and all governmental agencies, private entities, companies and/or individuals to release any and all information relating to the Applicant to CrimShield, and/or its agents, that is/are performing Applicant’s background investigation. Applicant understands that CrimShield may need a copy of Applicant’s social security card, driver license or other personal documentation, including, but not limited to, police reports, plea agreements, probation, or parole information and/or other information to complete the investigation. Applicant agrees to fully cooperate with and assist CrimShield to complete Applicant’s investigation(s). Applicant understands that if Applicant does not fully cooperate with and assist CrimShield in the investigation, then CrimShield has no duty to complete the investigation(s).
In regard to CrimShield performing and sharing Applicant’s investigative report, including the drug test results) the Parties agree that any claim, dispute or controversy whatsoever arising out of, or in any way related to, or associated with: the investigation; the publication and/or sharing of any investigation results; the release or reporting of any information regarding Applicant’s background investigation or any information about Applicant to any third party,
and/or; any alleged or actual violation of any law, statute, rule, or ordinance, shall all be decided solely and only by Arbitration through the American Arbitration Association and NOT through or by any Federal, State, County, City or local court system. The prevailing Party may certify the AAA ruling for purposes of an enforceable judgement in the appropriate Court of Law.\n
The Parties waive any and all rights to a jury trial or to trial by a judge. Additionally, the Parties waive any and all rights to appeal of any Arbitration decision.
The Parties waive any right to join any claim(s) with claims of others in any form of class action or any similar procedure regarding any claim, dispute or controversy arising out of, or in any way related to, or associated with: the investigation; the publication or sharing of any investigation results; the release or reporting of any information regarding Applicant’s background investigation or any information about Applicant to any third party, or; any alleged or actual violation of law, statute, rule, or ordinance, and the Parties agree that any claim that the Parties may bring, may and shall only be asserted individually and in no other way.
The Parties further agree that Mesa, Arizona is the exclusive venue and jurisdiction for Arbitration. The Parties agree that any cause of action brought by either Party must be filed within one calendar year from the time any claim or cause of action arises, otherwise said claims and causes of action are forever waived and released.
Notwithstanding anything set forth in this agreement, if there is any clause in any law, statute, rule, regulation or ordinance that prohibits any clause, provision or sentence in this agreement, then that applicable law, statute, rule, regulation, or ordinance shall govern any prohibited clause, provision or sentence in this agreement and nothing in this agreement shall be viewed as, or considered as, a violation of this agreement.
The Parties agree that CrimShield is not: A.) an employer of any kind for any entity or person in relationship to the background investigation or the investigative report; B.) a user of any of Applicant’s background investigation information; C.) a decision maker of any kind in relationship to any background investigation for the purpose of being granted or not granted a security clearance by Applicant’s employer/prospective employer.
The Parties agree that Applicant may write to CrimShield at P.O. Box 5960, Mesa AZ, 85211, or email CrimShield at investigations@crimshield.com.
The Parties agree the Parties have no other rights than those stated in this agreement. The Parties certify and warrant that all the information contained in this document are true and correct.