My signature below constitutes authorization to check my employment history, including without limitation, evaluations, criminal arrest and conviction record checks, reference checks, and release of investigatory information possessed by any agency. I further authorize those persons, agencies or entities that JAG contacts in connection with my employment application to fully provide any information on the matters set forth above. I expressly waive in connection with any request for or provision of such information, any claims including without limitation, defamation, emotional distress, invasion of privacy, or interference with contractual relations that I might otherwise have against JAG, its agents and officials or against ay provider of such information.
I affirm that I have never been convicted, or charged with and had the charges plea-bargained to a lesser offense, of any of the following offenses involving children as defined by Louisiana Code: rape, criminal deviate conduct, child molesting, child exploitation, vicarious sexual gratification, child solicitation, incest, child selling, child seduction or sexual battery.