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Authorization for Background Screening [Compatibility Mode]

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Background Check: Security Investigation Consent and Release Authorization


I, , hereby authorize STILLMAN COLLEGE and any entity directed by STILLMAN COLLEGE to obtain a “background investigation report” (sometimes called a “consumer report”) as part of its pre-employment background check.

I understand that this background investigation report addresses the following subjects: Work history; Education history; Court records, including criminal conviction records as permitted by law; Driving history, if job related; Employment references from professional obtained from personal interviews.

I further authorize all my previous employers and or references to provide such information about me to STILLMAN COLLEGE or any other entity that obtains information for STILLMAN COLLEGE. I release all respondents from any liability for releasing information.

I understand that STILLMAN COLLEGE and its agents are not responsible for the accuracy
or completeness of the information contained in any background investigation report. I release STILLMAN COLLEGE and its agents from all liability, claims and lawsuits with respect to the information obtained from any or all of the sources consulted in the investigation.

I understand that I will receive a free copy of any background investigation report and/or investigative consumer report requested by STILLMAN COLLEGE about me at the same time the report is provided to STILLMAN COLLEGE. (Check the box below if you would like a copy of the report sent to you).

This authorization in original or copy form shall be valid for one year from the date indicated next to my signature. According to the Fair Credit Reporting Act and, I will be notified by STILLMAN COLLEGE if employment is denied because of information obtained from a Consumer Reporting Agency. Additionally, I understand that pursuant to the Fair Credit Reporting Act, if requested within 60 days, I will be given full disclosure as to the nature and substance of all information provided to STILLMAN COLLEGE.

I understand that this authorization is not an offer for employment by STILLMAN COLLEGE, and that any false or misleading information I have provided to STILLMAN COLLEGE may result in a refusal to hire, promote, reassign, or could result in termination of employment no matter when the false or misleading information is discovered.

I have received and read the attached disclosure regarding STILLMAN COLLEGE’S right to obtain a background investigation report for employment purposes, and I authorize STILLMAN COLLEGE to obtain such a report.


As an applicant for a position with STILLMAN COLLEGE, I have been requested to furnish information for use in determining my qualifications. To that end, I hereby authorize the release and full disclosure of any information that you may have concerning my employment with STILLMAN COLLEGE.

I authorize you to release such employment information to those employees and agents of STILLMAN COLLEGE who require such information in order to make a decision with respect to any matter pertaining to my status as an employee. This information may be provided either verbally or in writing.

In addition to authorizing the disclosure and release of any information regarding my employment, I hereby fully waive any rights or claims I have or may have against Certified Background , its agents, employees, and representatives for providing such information, and fully release them from any and all liability, claims, or damages that may directly or indirectly result from the use, disclosure or release of any such employment information, whether such information is favorable or unfavorable to me.

I acknowledge that I have read this authorization and release, fully understand it, and voluntarily agree to its provisions. This release will expire one (1) year after the date signed.

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  • Yes, I wish to receive a copy of any background investigation report requested about me by STILLMAN COLLEGE.
  • IF APPLICABLE: Yes, I wish to receive a copy of any investigative consumer report requested about me by STILLMAN COLLEGE.