In connection with my application for volunteering, employment, or promotion or change in volunteer or employment status, I hereby certify that I have not been subject to allegations of child abuse or endangerment and by submitting this form I hereby instruct and authorize the Organization to which I am applying to obtain or authorize the obtaining of background check reports on me including but not limted to Investigative Consumer Report(s) that may include information as to my character, general reputation, personal characteristics and mode of living. Such reports may reveal information about my criminal background, work habits, assessments of my job performance, experiences and abilities, along with reasons for termination of past employment. Such reports may be requested by the Organization or on behalf of the Organization. Further, I understand and agree that the Organization and/or Consumer Reporting Agency may request information from various federal, state, and other agencies, including public and private sources which maintain records concerning my past activities relating to my driving record, credit history, criminal record, civil matters, previous employment, educational background and professional licensing, if any. The information provided on this form is subject to verification, which may include a criminal history check and request from any Central Registry of child abusers. The Organization may terminate volunteer or employment services of any person if that person is found, regardless of when discovered, to have a history of complaints of abuse of a minor, have resigned, been terminated, or been asked to resign from a camp position whether paid or unpaid as a result of any complaints or allegations of misconduct of any kind and/or, have falsified or omitted information in this disclosure statement