Background Check Authorization Form

Background Check Authorization Form
Trinity Bible College and Graduate School reserves the right to conduct background checks of students for security purposes. All information will be kept strictly confidential.
I'm filling this form out for:*

Undergraduate/Pack Your BagsGraduate School (Master's or PhD)CMT/MyTrinityOnline
Name*

First NameLast Name
Any other names used:
Current Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Permanent Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birthdate*

MonthDayYear
Date
SSN*
Have you ever been arrested and convicted of any criminal offense(s)?*

YesNo
I hereby authorize Trinity Bible College and Graduate School to make an independent investigation of my background and criminal or police records. I release Trinity, and any person or entity which provides information pursuant to this authorization, from any and all liabilities, claims, or lawsuits in regards to the information obtained from any and all of the above sources. I agree to waive any right to bring legal action against Trinity or the background check agency for the disclosure of such information. The information contained on this form is correct to the best of my knowledge.
Signature*

Clear
Date*

MonthDayYear
Date
If applicant is under the age of 18, a parent or legal guardian must sign below for authorization.
Signature (of parent or legal guardian)

Clear
Date

MonthDayYear
Date
Should be Empty: