DISCLOSURE NOTICE AND AUTHORIZATION REGARDING
BACKGROUND CONSUMER REPORTS
Important: Please read carefully before signing.
PART B
Please return this form to the Clovis Community College Human Resource Services
Office. It should not, however, be attached to your application.
DISCLOSURE
A consumer report and/or investigative consumer report including information concerning your
character, employment history, general reputation, personal characteristics, police record,
criminal records, education, qualifications and/or credit and indebtedness may be obtained in
connection with your application for and/or continued employment with the employer. These
reports may include experience information along with reasons for termination of past
employment. Further, understand that information from various Federal, State, local and other
agencies which contain your past activities may be requested at any time during the application
process or during your employment with the company.
The name, address and telephone number of the Company preparing the report is: First
Advantage P.O. Box 3367 Seminole, FL 33775-3367; Toll free number: 1-800-321-4473
ext. 8. Their privacy Policy can be reviewed at http:// www.fadv.com/privacy-policy.
Please be advised that you have a right to inspect the files that the Consumer Reporting
Agency may have on you during normal business hours and upon you furnishing proper
identification.
AUTHORIZATION
This application is only valid for the position applied for as listed on page 1. I understand that
my status as an applicant will end at the close of this job search. I understand that if the hiring
department feels the applicant pool is inadequate, the search may be extended or suspended. I
understand that I may apply for employment in the future by completing a new application for
any vacant position. I understand that if an employee is terminated for cause, released under
the probationary period, or resigned after disciplinary actions, the employee will not be
eligible for future employment with Clovis Community College in any capacity. I certify that
previous employment with CCC did not end under the circumstances mentioned above.
By signing below, you hereby authorize without reservation, any party or agency contacted
by this employer to furnish the above mentioned information. You further authorize ongoing
procurement of the above mentioned reports at any time during your employment (or
contract). You also agree that a fax or photocopy of this authorization with your signature be
accepted with the same authority as the original.