Grace Creek Church - Background Check & Confidentiality Agreement

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DISCLOSURE and AUTHORIZATION - BACKGROUND INVESTIGATION

In connection with my application for employment or to serve as a volunteer with Grace Creek Church ("Client'), I understand that a "investigative consumer report", as defined by the Fair Credit Reporting Act, will be requested by Client for employment or volunteer purposes, whichever is applicable, from Protect MyMinistry, Inc., ("Protect My Ministry" a consumer reporting agency as defined by the Fair Credit Reporting Act. These reports may include information as to my character, general reputation, personal characteristics or mode of living, whichever are applicable. They may involve interviews with sources such as my neighbors, friends or associates. The report may also contain information about me relating to my criminal history, credit history, driving and/or motor vehicle records, social security number verification, verification of education or employment history, worker's compensation (only after a conditional job offer) or other background checks. Such reports may be obtained at any time after receipt of this Disclosure and Authorization and if I am hired or serve as a volunteer, whichever is applicable, throughout the course of my employment or volunteer service, as permitted by law and unless revoked by me in writing. I understand that I have the right, upon written request made within a reasonable amount time after the receipt of this notice, to request disclosure of the nature and scope of any investigative consumer report to Protect My Ministry, Inc., 14499 N. Dale Mabry Hwy., Suite 201 South, Tampa, FL 33618 or 1-800-319- 5581. For information about Protect My Ministry's privacy practices, see www.protectmyministry.com.
NAME*

FIRST NAMEMIDDLE NAMELAST NAME
HOME ADDRESS*
CITY*
COUNTY*
STATE*
ZIP CODE*
SOCIAL SECURITY #*
DL # or ID #*
STATE ISSUED*
DATE OF BIRTH*

MonthDayYear
Date
E MAIL ADDRESS*
example@example.com
PHONE/CELL NUMBER*
Format: (000) 000-0000.
PLEASE LIST ANY OTHER NAMES USED
Acknowledgement and Authorization

By signing below, I voluntarily and knowingly authorize Grace Creek Church or its authorized agents to obtain or prepare consumer reports or investigative consumer reports about me. I acknowledge receipt of a copy of A Summary of Your Rights under the Fair Credit Reporting Act and certify that I have read this Disclosure and Authorization as well as the summary explaining my rights under the Fair Credit Reporting Act.
Signature of Applicant*

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DATE*

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Date
Signature of Applicant As the parent/guardian of the above-referenced minor, I hereby provide my consent for above- mentioned information to be obtained.
CONFIDENTIALITY AGREEMENT

THIS CONFIDENTIALITY AGREEMENT (“Agreement”) is hereby and between GraceCreek Church (“Church”) and (referred to as “I” or “me” below). WHEREAS, the Church and I agree that the Bible was inspired by God and written by man without error and is completely relevant to our daily life;WHEREAS, the Scripture forbid the spreading of gossip, slander, and the betraying of confidences (Exodus 23:1, Leviticus 19:16,Proverbs 6:9, 11:13, 16:28, 20:19, Romans 1:30 and 1 Corinthians 6:10);WHEREAS, as an inducement of the Church to allow me to volunteer, or to hire me or continue to employ me, or to provide me access to Confidential Information, or to provide me compensation benefits, as the case may be, I have agreed to execute this Agreement and be bound by its terms and covenants.NOW, THEREFORE, in consideration of the above premises, I agree to be bound by the terms, conditions and covenants set for thherein: Duty to Maintain Confidentiality. I promise and agree that, except to the extent the use or disclosure of and Confidential Information(as defined below) is required to carry out my assigned duties within the Church, during my employment or volunteering with theChurch and thereafter: (a) I will keep strictly Confidential and not disclose to any person not employed by the Church and ConfidentialInformation and not disclose to any person not employed by the Church and Confidential Information, and (b) I will not use for myself, for any other person or entity, any Confidential Information.However, this provision shall not preclude me: (i) from the use or disclosure of information known generally to the public, other than asa result of my violation of this Section; or (ii) from any disclosure required by law or court order, so long as I provide the Church immediate written notice of any potential disclosure pursuant to this subsection and take all reasonable and lawful steps to limit to the extent of such disclosure.Definition. The term “Confidential Information” means all non-public information furnished to, obtained by, or created by me within the course and scope of my work (volunteer or otherwise) with the Church. Confidential Information includes, but is not limited to, such information relating to: (i) Church participants, including lists, contact information, prayer requests, personal information; (ii) theChurch’s finances, including personal financial salary information related to the staff, the Church’s financial statements, balance sheets, offerings information, cash flow, forecasts and cost analyses; (iii) the Church’s plans and projections for opportunities for new or developing ideas; and/or (iv) the Church’s research and development activities and technical data.Return of Property. I agree that all Church property, files, documents, equipment, data, and information used, prepared, or collected by me as part of my employment or volunteering with the Church, in whatever form, will at all times remain the property of the Church.I also agree that all Confidential Information that comes into my possession, whether prepared by me or others, is and will remain the.Property of the Church, I agree that I will return upon the Church’s request at any time (and, in any event, prior to the end of my employment or volunteering with the Church) all property, files, documents, equipment, data and information belonging to the Church in my possession or control, regardless of how stored or maintained and including all originals and copies.I recognize that the terms of this Agreement are necessary to protect the Church’s confidential information and the sensitivity of such information. I also agree that its terms are fair and reasonable. Thus, I agree not to contest general validity or enforceability of thisAgreement. The covenants in this Agreement shall survive the termination or end of my employment or volunteering with the Church as set forth above, regardless of the date, reason, or manner of my separation. I acknowledge that this Agreement is supported by good and valuable consideration.IN WITNESS WHEREOF, the parties have duly executed this Confidentiality Agreement as of the date stated above written.
Date*

MonthDayYear
Date
Full Name*

First NameLast Name
Signature*

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Name*
City*
State
Zip Code
Primary Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
BUSINESS DIRECTOR*
example@example.com
Should be Empty:

CONFIDENTIALITY AGREEMENT