ISSREV - SecurTest Consumer Authorization for ISS Self Pay

You are now on the webpage for the SecurTest, Inc. online background screening authorization form, over which International Schools Service, Inc. has no control or access to. In order to initiate a background check with SecurTest, Inc., you must complete this authorization document that is NOT shared with ISS and in which you agree ISS has no liability. Further, you agree that upon completing the authorization documentation and upon receipt of the background check results which you have reviewed and approved, if those results are authorized to be sent to ISS, then ISS will have no liability for, and will be indemnified and held harmless against, any and all claims by you or which arise as a result of the inclusion and use of your background check results in the application process and for the decisions of the various school administrators using those results in assessing your candidacy for any of the positions at the particular international schools involved.
I Understand and Agree

Disclosure and Authorization
This authorization is required for us to complete your background check for International Schools Services, Inc. (hereafter "ISS"). The information you provide in this form is confidential and secure.

By completing the authorization online, you hereby certify that your electronic signature may be used as if it were your original handwritten signature by iReviewNow, SecurTest, Inc., and/or court researchers, investigators, or government entities to verify your authorization for your background check. You hereby give consent for SecurTest, Inc. to periodically re-check your background report without further notice or consent.

You may complete this authorization online by pressing "Next." The authorization will not be complete until you click the "Submit" button on the final page. You must complete this authorization in one sitting. Your information is SSL encrypted and secure.

Background Check Participation
As part of your application, SecurTest, Inc. will conduct your background check.

Please read the following Consumer Authorization form in its entirety. The language in the disclosure statements is required under the Fair Credit Reporting Act. SecurTest’s background investigation is restricted to verification of your identity, verification of your Social Security Number, and a comprehensive criminal conviction search.

An important feature of the SecurTest background check includes iReviewNow®, a patented solution that allows you to view your report at the same time we do. Thus, please provide your email and cell phone number so that SecurTest can send you your report or information on how to securely view it online. You are an important part of the background screening process. Reviewing your report will ensure that you have authenticated its accuracy, identified any inaccuracies, file any disputes, explain any information, and provide any self-improvement steps you wish us to consider. iReviewNow, LLC is not a consumer reporting agency, but the exclusive system that allows you to instantly view and comment on your background report.

The information you provide is secured and is neither sold nor redistributed by SecurTest or iReviewNow, LLC. Be sure to carefully complete each form. You may contact SecurTest at (800) 445-8001 or compliance@securtest.com if you have any questions.

Thank you for your participation and cooperation in this important step.

You must answer each question and press "Next."

The website and form are confidential and secure. You can be confident that your personal identifiers are protected and encrypted.
I. I understand that an investigative report will be prepared and reported by SecurTest concerning my background, including any criminal history information, authentication of my identity, validity of any social security number issued by the Social Security Administration, and other background information. The Summary of Rights under the FCRA details additional information as defined by the FCRA. This background check is limited to an investigation of criminal records, validation of your identity and residence history, Motor Vehicle Records Search, and Employment Verification.

I understand that SecurTest, Inc. and or its background screening agents or investigators, or authorized parties, may be requesting information from public and private sources about any of the information noted earlier in this paragraph in connection with the company or organization requesting this investigative report. We do not check your credit report without an additional notice and authorization.

II. IF APPLICABLE, Medical and worker’s compensation information will only be requested in compliance with the Federal Americans with Disabilities Act (ADA) and/or any other applicable state laws. According to the Fair Credit Reporting Act (FCRA, Public Law 91-508, Title VI), I am entitled to know if the considerations for which I am applying are denied because of information obtained from a consumer reporting agency. If so, I will be notified and be given the name of the agency providing that report. This section II does not apply to you, though we must communicate this information to you.

III. I acknowledge that a telephonic, electronic, online, facsimile (FAX) or photographic copy of this release shall be as valid as the original. This release is valid for most federal, state and county agencies. I have received a copy of my Fair Credit Reporting Act (FCRA) rights found on page 7.

IV. I hereby authorize, without reservation, any financial institution, law enforcement agency, clerk of court, government agencies that store records, information service bureau, school, employer or insurance company contacted by SecurTest, Inc., or their background screening agents, investigators, or entities to furnish the information described in Section I.

V. As the subject of an international background check, we must rely on court researchers located in the various countries that allow a background investigation. SecurTest cannot be either an insurer or a guarantor of the accuracy of the information received from international police, courts or other sources, and as such, rely on you to complete iReviewNow to ensure the accuracy of your report. Therefore, I release and forever hold harmless SecurTest, their Affiliates, Assigns, their officers, agents, and employees from liability for any negligence of third party furnishers of my criminal history file obtained outside the United States of America.
VI. I understand that if I am a resident of California, Minnesota, Oklahoma, Connecticut, or New York, I may obtain a copy of the background report.

I understand.
Please note, regardless of your state of residency, you will have automatic access to your report through iReviewNow.

Please Carefully Complete the Following
As part of the background investigation for ISS, we verify the information you provide as being accurate.

The website and form are confidential and secure. You can be confident that your personal identifiers are protected and encrypted.
Your Legal First Name*
Your Legal Last Name*
Your Legal Middle Name (if any)
Your Maiden Name (if any)
Email*
example@example.com
Have you ever used any other Name(s)?*

YesNo
Please list any other Name(s) Used. If you have used multiple names, please separate each name by pressing Enter.*
You must pay securely online using a VISA or Mastercard credit or debit card. We do not accept American Express*

I understand and agree.
Please Note: Payment is processed after you click "Submit". Be sure to carefully review your authorization before submitting.

Please Carefully Complete the Following
The following information is required by courts, law enforcement agencies, and other entities for positive identification purposes when checking public, government or official records. It is confidential and will not be used for any other purposes.

You MUST answer each question.
Who must be fingerprinted? The purpose of the fingerprints is to conduct a US based background check. So, who should be fingerprinted?

1. US Citizens must submit fingerprints.
2. Non-US Citizens that have lived in the US in the past 10 years (past your 18th birthday).

Who does not need to be fingerprinted?

NON-US CITIZENS that have not lived in the U.S. will not be required to submit fingerprints.

Finding a fingerprinting location in the USA. Generally, your local Sheriff's Office provides fingerprinting services.

Finding a fingerprinting location outside the USA. You will need to take the fingerprint card and FBI information form to be fingerprinted. Your prints must be rolled in ink on the FBI card and meet the legibility standards of the FBI. Contact the local US Embassy or Consulate to determine if they can fingerprint you. You may need to contact local law enforcement agencies as well. Mail by Certified Mail or send by Overnight Express for faster processing of the FINGERPRINT CARD and FBI INFORMATION FORM in a large thick envelope that protects the card from being folded or bent to the address we will provide to you in our email. We recommend that you use a certified carrier, such as FedEx. United Parcel Service (UPS) and DHL Express. Additional instructions will be emailed to you.
Please enter the address, IF DIFFERENT FROM WHAT YOU ENTERED, where you will be for the next month. This address will be used to schedule your FBI Fingerprinting.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Your Birth Date*

MonthDayYear
Do you have a Social Security Number?*

YesNo
Your Social Security Number*
Please only enter numbers (no dashes).
As part of International Background investigations, we are often prompted for additional information. Please carefully answer the questions below.
Your Father's Full Name*
Your Mother's Full Name (including Maiden Name)*
Please enter your Passport Number*
Enter the Country that issued the Passport*
Your Country of Citizenship*
Your Current Physical Address (Not a PO Box)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long have you lived at this address? Please answer in months.*
Do you have a different mailing address?*

YesNo
Mailing Address if different than above.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Have you lived at an another U.S. address within the past 10 years?*

YesNo
First Previous Physical Address (Not a PO Box)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived at an another U.S. address within the past 10 years?*

YesNo
Second Previous Physical Address (Not a PO Box)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived at an another U.S. address within the past 10 years?*

YesNo
Third Previous Physical Address (Not a PO Box)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived at an another U.S. address within the past 10 years?*

YesNo
Fourth Previous Physical Address (Not a PO Box)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived at an another U.S. address within the past 10 years?*

YesNo
Fifth Previous Physical Address (Not a PO Box)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived at an another U.S. address within the past 10 years?*

YesNo
Sixth Previous Physical Address (Not a PO Box)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived at an another U.S. address within the past 10 years?*

YesNo
Seventh Previous Physical Address (Not a PO Box)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived at an another U.S. address within the past 10 years?*

YesNo
Eighth Previous Physical Address (Not a PO Box)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived at an another U.S. address within the past 10 years?*

YesNo
Ninth Previous Physical Address (Not a PO Box)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived at an another U.S. address within the past 10 years?*

YesNo
Tenth Previous Physical Address (Not a PO Box)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Please note, if you have resided in a non-U.S. country within the past 10 years at the minimum age of 18 years or older, please list all of your foreign addresses within the past 10 years below.
First Previous International Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived in another non-U.S. country within the past 10 years at the minimum age of 18 years or older?

YesNo
Second Previous International Address

Street Address

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CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived in another non-U.S. country within the past 10 years at the minimum age of 18 years or older?

YesNo
Third Previous International Address

Street Address

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CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived in another non-U.S. country within the past 10 years at the minimum age of 18 years or older?

YesNo
Fourth Previous International Address

Street Address

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CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived in another non-U.S. country within the past 10 years at the minimum age of 18 years or older?

YesNo
Fifth Previous International Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived in another non-U.S. country within the past 10 years at the minimum age of 18 years or older?

YesNo
Sixth Previous International Address

Street Address

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CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived in another non-U.S. country within the past 10 years at the minimum age of 18 years or older?

YesNo
Seventh Previous International Address

Street Address

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CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived in another non-U.S. country within the past 10 years at the minimum age of 18 years or older?

YesNo
Eighth Previous International Address

Street Address

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CityState / Province

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How long did you live at this address? Please answer in months.*
Have you lived in another non-U.S. country within the past 10 years at the minimum age of 18 years or older?

YesNo
Ninth Previous International Address

Street Address

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CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived in another non-U.S. country within the past 10 years at the minimum age of 18 years or older?

YesNo
Tenth Previous International Address

Street Address

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CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived in another non-U.S. country within the past 10 years at the minimum age of 18 years or older?

YesNo
Eleventh Previous International Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived in another non-U.S. country within the past 10 years at the minimum age of 18 years or older?

YesNo
Twelfth Previous International Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived in another non-U.S. country within the past 10 years at the minimum age of 18 years or older?

YesNo
Thirteenth Previous International Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived in another non-U.S. country within the past 10 years at the minimum age of 18 years or older?

YesNo
Fourteenth Previous International Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*
Have you lived in another non-U.S. country within the past 10 years at the minimum age of 18 years or older?

YesNo
Fifteenth Previous International Address

Street Address

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CityState / Province

Postal / Zip CodeCountry
How long did you live at this address? Please answer in months.*

Contact Information
Your Email Address is REQUIRED*
Your Cell Phone Number. While this field is optional, we can use SMS Text Messaging to notify you that your background report has been completed and is available for your review. Note: SMS Text Message charges may apply.

Area CodePhone Number
Your cell phone provider:*
ex: Sprint, AT&T, T-Mobile, etc

A Summary of Your Rights Under the Fair Credit Reporting Act
Para información en español, visite www.consumerfinance.gov/es, o escriba: Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20006

The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of information in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under the FCRA. For more information, including information about additional rights, go to www.consumerfinance.gov/learnmore or write to: Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC 20006.

§        You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or employment – or to take another adverse action against you – must tell you, and must give you the name, address, and phone number of the agency that provided the information.

§        You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your "file disclosure"). You will be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if:

§        a person has taken adverse action against you because of information in your credit report;

§        you are the victim of identify theft and place a fraud alert in your file;

§        your file contains inaccurate information as a result of fraud;

§        you are on public assistance;

§        you are unemployed but expect to apply for employment within 60 days.

In addition, all consumers are entitled to one free disclosure every 12 months upon request from each nationwide credit bureau and from nationwide specialty consumer reporting agencies. See www.consumerfinance.gov/learnmore for additional information.

§        You have the right to ask for a credit score. Credit scores are numerical summaries of your credit-worthiness based on information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit score information for free from the mortgage lender.

§        You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is incomplete or inaccurate, and report it to the consumer reporting agency, the agency must investigate unless your dispute is frivolous. See www.consumerfinance.gov/learnmore for an explanation of dispute procedures.

§        Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate, incomplete or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate.

§        Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years old.

§        Access to your file is limited. A consumer reporting agency may provide information about you only to people with a valid need – usually to consider an application with a creditor, insurer, employer, landlord, or other business. The FCRA specifies those with a valid need for access.

§        You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out information about you to your employer, or a potential employer, without your written consent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to www.consumerfinance.gov/learnmore.

§        You may limit "prescreened" offers of credit and insurance you get based on information in your credit report. Unsolicited "prescreened" offers for credit and insurance must include a toll-free phone number you can call if you choose to remove your name and address from the lists these offers are based on. You may opt-out with the nationwide credit bureaus at 1-888-567- 8688.

§        You may seek damages from violators. If a consumer reporting agency, or, in some cases, a user of consumer reports or a furnisher of information to a consumer reporting agency violates the FCRA, you may be able to sue in state or federal court.

§        Identity theft victims and active duty military personnel have additional rights. For more information, visit www.consumerfinance.gov/learnmore.
States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact your state or local consumer protection agency or your state Attorney General. For information about your federal rights, contact:

TYPE OF BUSINESS: CONTACT:

1. Type of business: a) Banks, savings associations, and credit unions with total assets of over $10 billion and their affiliates. b) Such affiliates that are not banks, savings associations, or credit unions also should list, in addition to the Bureau:	a) Bureau of Consumer Financial Protection 1700 G Street NW Washington, DC 20006 b) Federal Trade Commission: Consumer Response Center – FCRA Washington, DC 20580 (877) 382-4357
2. To the extent not included in item 1 above: a) National banks, federal savings associations, and federal branches and federal agencies of foreign banks b) State member banks, branches and agencies of foreign banks (other than federal branches, federal agencies, and insured state branches of foreign banks), commercial lending companies owned or controlled by foreign banks, and organizations operating under section 25 or 25A of the Federal Reserve Act c) Nonmember Insured Banks, Insured State Branches of Foreign Banks, and insured state savings associations d) Federal Credit Unions	a) Office of the Comptroller of the Currency Customer Assistance Group 1301 McKinney Street, Suite 3450 Houston, TX 77010-9050 b) Federal Reserve Consumer Help Center P.O. Box 1200 Minneapolis, MN 55480 c) FDIC Consumer Response Center 1100 Walnut Street, Box #11 Kansas City, MO 64106 d) National Credit Union Administration Office of Consumer Protection (OCP) Division of Consumer Compliance and Outreach (DCCO) 1775 Duke Street Alexandria, VA 22314
3. Air carriers	Asst. General Counsel for Aviation Enforcement & Proceedings Department of Transportation 400 Seventh Street SW Washington, DC 20590
4. Creditors Subject to Surface Transportation Board	Office of Proceedings, Surface Transportation Board Department of Transportation 1925 K Street NW Washington, DC 20423
5. Creditors Subject to Packers and Stockyards Act	Nearest Packers and Stockyards Administration area supervisor
6. Small Business Investment Companies	Associate Deputy Administrator for Capital Access United States Small Business Administration 406 Third Street, SW, 8th Floor Washington, DC 20416
7. Brokers and Dealers	Securities and Exchange Commission 100 F St NE Washington, DC 20549
8. Federal Land Banks, Federal Land Bank Associations, Federal Intermediate Credit Banks, and Production Credit Associations	Farm Credit Administration 1501 Farm Credit Drive McLean, VA 22102-5090
9. Retailers, Finance Companies, and All Other Creditors Not Listed Above	FTC Regional Office for region in which the creditor operates or Federal Trade Commission: Consumer Response Center – FCRA Washington, DC 20580 (877) 382-4357

Consumers Have the Right To Obtain A Security Freeze

Pursuant to Title III of the “Economic Growth, Regulatory Relief, and Consumer Protection Act” (PL No. 115-174), you have a right to place a “security freeze” on your credit report, which will prohibit a consumer reporting agency from releasing information in your credit report without your express authorization. The security freeze is designed to prevent credit, loans, and services from being approved in your name without your consent. However, you should be aware that using a security freeze to take control over who gets access to the personal and financial information in your credit report may delay, interfere with, or prohibit the timely approval of any subsequent request or application you make regarding a new loan, credit, mortgage, or any other account involving the extension of credit.

As an alternative to a security freeze, you have the right to place an initial or extended fraud alert on your credit file at no cost. An initial fraud alert is a 1-year alert that is placed on a consumer’s credit file. Upon seeing a fraud alert display on a consumer’s credit file, a business is required to take steps to verify the consumer’s identity before extending new credit. If you are a victim of identity theft, you are entitled to an extended fraud alert, which is a fraud alert lasting 7 years.
A security freeze does not apply to a person or entity, or its affiliates, or collection agencies acting on behalf of the person or entity, with which you have an existing account that requests information in your credit report for the purposes of reviewing or collecting the account. Reviewing the account includes activities related to account maintenance, monitoring, credit line increases, and account upgrades and enhancements.
To place a security freeze or fraud alert on your credit report please contact the following consumer reporting agencies:

Equifax
https://www.freeze.equifax.com/Freeze/jsp/SFF_PersonalIDInfo.jsp

https://www.alerts.equifax.com/AutoFraud_Online/jsp/fraudAlert.jsp

Experian

https://www.experian.com/freeze/center.html
https://www.experian.com/fraud/center.html

TransUnion

https://www.transunion.com/credit-freeze/credit-freeze-faq.page

https://www.transunion.com/fraud-victim-resource/place-fraud-alert

BACKGROUND CHECK AUTHORIZATION

I hereby agree, authorize and consent to the preparation of consumer reports and investigative consumer reports ("Background Reports") about me by SecurTest, Inc., a consumer reporting agency. I further authorize and consent to the procurement of Background Reports about me by INTERNATIONAL SCHOOL SERVICES, hereafter the "Employer", which I understand may contain information about my criminal history, character, general reputation, personal characteristics, and/or mode of living.

By completing the authorization online, you hereby certify that your electronic signature may be used as if it were your original handwritten signature by SecurTest, Inc., and/or court researchers, investigators, or government entities to verify your authorization for your background check.

I authorize SecurTest, Inc., subject to any applicable laws protecting my privacy, to collect various types of information to prepare a background report that may include, but are not limited to domestic and international criminal records, sex offender databases, employment records, education records, professional credential and license records, department of motor vehicle records ("driving records"), military records, professional and personal references, government sanctions and exclusions databases, and where it applies to the position DOT regulated employer records in compliance with 49 CFR 382.

I authorize any local, state, federal or international law enforcement agency, public or private agency, administrator, public or private institution, public or private school or university, information services bureau, employer, insurance company, credit bureaus, or any other party holding information under my name to furnish any and all background information requested by SecurTest for the purpose of providing a background report to the “Employer”.

I agree, authorize and consent to the release and disclosure of any and all information about me by SecurTest to the “Employer”, and where “Employer” is pursuing my direct or temporary engagement with a third party, Company may provide that third party with a copy of my Report. You hereby give consent for SecurTest, Inc. to periodically re-check your background report without further notice or consent.

I hereby authorize SecurTest to provide me with any notices, including those required by federal, state or local laws, on behalf of itself or at the mailing address(es) and/or email address(es) I have provided to SecurTest and/or to the “Employer, its client.

This authorization electronically or physically signed by me shall be valid as allowable by law without my further authorization from the date of execution and throughout my engagement with the Employer. I agree that a copy of this document by fax or other electronic means shall be as valid as the original.
Signature*

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FAIR CREDIT REPORTING ACT NOTICE
In accordance with the Fair Credit Reporting Act (FCRA, Public Law 91-508, Title VI), this information may only be used to verify a statement(s) made by an individual in connection with legitimate business needs. The depth of information available varies from state to state. Status of updates is available on request. Although SecurTest, Inc. has used reasonable methods and standards in its background screening and collection of information and every effort has been made to assure accuracy, SecurTest relies on sources of information which are outside of the control of SecurTest, as they are county, state, federal, and other official records. Final verification of an individual’s identity and proper use of report contents are the responsibility of International Schools Services, Inc. SecurTest, Inc.’s policy requires purchasers of these reports to have signed a Service Agreement. This assures SecurTest, Inc., providers of official records, and SecurTest researchers, background screening investigators, and sources for such information that users of your report will abide by the FCRA and other legal obligations. If information contained in this report is responsible for disqualification, suspension or termination the requesting agency of this background report has agreed to give you immediate access to your SecurTest Report, iReviewNow, and your FCRA rights, among other required documentation.

By submitting my information, as the subject of the background check, I certify that I have received a copy of my FCRA Rights. I further affirm receipt of a copy of my SecurTest Background Report to the email provided and use of iReviewNow to verify the accuracy of the report.

I understand I can instantly review my report for FREE, identify errors or mistakes, report identity theft, dispute inaccuracies, provide comments using the iReviewNow Compliance System.

I agree to exclusively use iReviewNow to verify the accuracy of my background report, identify errors or mistakes, report identity theft, and dispute inaccuracies, and provide comments or feedback.
Signature - Use Your Mouse to Sign in the Box*

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Type your full legal name as your electronic signature.
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I am a California Resident*

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NOTICE REGARDING BACKGROUND CHECKS AND
CREDIT CHECKS PER CALIFORNIA LAW

The Employer (the “Company”) intends to obtain information about you for employment screening purposes from a consumer reporting agency. Thus, you can expect to be the subject of “investigative consumer reports” and “consumer credit reports” obtained for employment purposes. Such reports may include information about your character, general reputation, personal characteristics and mode of living. With respect to any investigative consumer report from an investigative consumer reporting agency (“ICRA”), the Company may investigate the information contained in your employment application and other background information about you, including but not limited to obtaining a criminal record report, verifying references, work history, your social security number, your educational achievements, licensure, and certifications, your driving record, and other information about you, and interviewing people who are knowledgeable about you. The results of this report may be used as a factor in making employment decisions. The source of any investigative consumer report (as that term is defined under California law) will be SecurTest, Inc., 600 Grand Panama Blvd, Suite 202, Panama City Beach, FL 32407; tel. # (800) 445-8001; www.securtest.com.   The Company agrees to provide you with a copy of an investigative consumer report when required to do so under California law.

Under California Civil Code section 1786.22, you are entitled to find out what is in the ICRA’s file on you with proper identification, as follows:

*          In person, by visual inspection of your file during normal business hours and on reasonable notice. You also may request a copy of the information in person. The ICRA may not charge you more than the actual copying costs for providing you with a copy of your file.
*          A summary of all information contained in the ICRA’s file on you that is required to be provided by the California Civil Code will be provided to you via telephone, if you have made a written request, with proper identification, for telephone disclosure, and the toll charge, if any, for the telephone call is prepaid by or charged directly to you.
*          By requesting a copy be sent to a specified addressee by certified mail. ICRAs complying with requests for certified mailings shall not be liable for disclosures to third parties caused by mishandling of mail after such mailings leave the ICRAs.

“Proper Identification” includes documents such as a valid driver’s license, social security account number, military identification card, and credit cards. Only if you cannot identify yourself with such information may the ICRA require additional information concerning your employment and personal or family history in order to verify your identity.

The ICRA will provide trained personnel to explain any information furnished to you and will provide a written explanation of any coded information contained in files maintained on you. This written explanation will be provided whenever a file is provided to you for visual inspection. You may be accompanied by one other person of your choosing, who must furnish reasonable identification. An ICRA may require you to furnish a written statement granting permission to the ICRA to discuss your file in such person’s presence.

Notice Regarding Credit Checks:
Pursuant to Section 1024.5 of the California Labor Code, the Company will not obtain a consumer credit report on you.
Please check this box if you would like to receive a copy of an investigative consumer report or consumer credit report at no charge if one is obtained by the Company whenever you have a right to receive such a copy under California law.

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THIS BACKGROUND CHECK DISCLOSURE IS PROVIDED AS A STANDALONE DOCUMENT.

I am a New York Resident*

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New York Disclosure

In connection with my application for employment (including contract for services) with International Schools Services, Inc.

I understand that consumer reports which may contain public record information and investigative consumer reports consisting of interviews with employers, neighbors, friends, and associates may be requested from SecurTest, Inc., a consumer reporting agency. These reports may include the following types of information: names of employers and dates of previous employment, reason for termination of employment, work experience, accidents, etc. I further understand that such reports may contain public record information concerning my driving record, workers’ compensation claims, credit, bankruptcy proceedings, criminal records, etc., from federal, state and other agencies which maintain such records. I hereby consent to your obtaining the above information from such agency.

I AUTHORIZE, WITHOUT RESERVATION, ANY PARTY OR AGENCY CONTACTED BY THE CONSUMER REPORTING AGENCY TO FURNISH THE ABOVE-MENTIONED INFORMATION.

I have the right to make a request to SecurTest, Inc upon proper identification, to request the nature and substance of all information in its files on me at the time of my request, including the sources of information; and the recipients of any reports on me which the agency has previously furnished within the two year period preceding my request.

I hereby authorize procurement of consumer report(s). If hired (or contracted), this authorization shall remain on file and shall serve as ongoing authorization for you to procure consumer reports and investigative consumer reports at any time during my employment (or contract) period.

I acknowledge receipt of a copy of Article 23-A of New York Correction Law.

New York State Labor Law §201-f provides that every employer shall post, in a place accessible to his or her employees, a copy of Correction Law Article 23-A relating to the licensure and employment of persons previously convicted of one or more criminal offenses.
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Have you live in the State of Georgia (USA) in past ten (10) years?*

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Georgia Name-Based Criminal History Record Information (CHRI) Consent/Inquiry Form
Full Name*

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Georgia requests your Race and Sex (Gender) to perform a more accurate and complete Criminal History Search. SecurTest will not use your answers in the employment process or share them with the employer or other parties.
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I hereby authorize SecurTest, Inc. and PSI Background Screening to conduct an inquiry for the purpose of Employment and receive any Georgia and/or national CHRI as authorized by state and federal law.

This authorization is valid for 90 days from the date of my signature.

I do not consent to the above-named entity performing periodic criminal history background checks for the duration of my employment.

Purpose Code Used (check one): Note: Only one inquiry may be performed per consent form.

NON-CRIMINAL JUSTICE PURPOSES
E = Employment
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Signature - Georgia*

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I hereby authorize iReviewNow, LLC and SecurTest, Inc. to transmit a copy of my background report to me in a secure electronic manner. I understand that receiving a copy of my report, use of iReviewNow, or providing responses or disputes using iReviewNow is a free service, which allows me instant access and other valuable benefits described in the Terms and Conditions found at iReviewNow.com and below.

I agree to the iReviewNow, LLC and SecurTest, Inc. terms and conditions.
INSTRUCTIONS FOR REQUESTING A COPY OF YOUR REPORT AT A FUTURE DATE:

You may go to iReviewNow.com to request a copy of your report in the future. You will be required to upload, scan color copies of your government issued identification, such as a driver’s license, state identification card, passport, birth certificate, or similar documentation to verify your identity. WE MUST HAVE YOUR DATE OF BIRTH, SOCIAL SECURITY NUMBER (where issued), ADDRESS, AND EMAIL TO FIND AND SEND YOU A COPY OF YOUR REPORT.
HOW TO CONTACT SECURTEST, INC.

SecurTest, Inc. ★ 600 Grand Panama Blvd. Ste. 202, Panama City Beach, FL 32407★ (800) 445-8001 (toll-free to speak to SecurTest) ★ Fax (866) 580-4851 ★ compliance@securtest.com ★ or by going to securtest.com

I hereby authorize SecurTest, Inc. and iReviewNow, LLC (not a consumer reporting agency) and its assigns to transmit my background report, including any FBI Rap Sheet and/or International Background Reports, or other background reports (collectively "Report"), to International Schools Services, Inc., its member schools, assigns, or affiliates (hereafter "ISS") following my receipt, review and approval of my completed Report via iReviewNow. Moreover, upon my approval via iReviewNow, I authorize ISS to transmit my report as may be required by various schools or potential employers seeking this information to make placement and/or hiring decision. I release and forever hold harmless ISS, SecurTest, Inc. and iReviewNow, LLC for releasing any or all of my background report or reports and my iReviewNow responses. ISS does not make hiring decisions or recommendations except for schools it manages or owns. All other employment or placement decisions are solely the responsibility of the employer. I also understand that if I do not review my Report via completion of the iReviewNow questionnaire, my report will not be transmitted to ISS.
I understand and agree to the statement above.
Please Note: After clicking Submit, payment will be processed according to the screenings and jurisdictions you selected herein. You understand there are no refunds once you click Submit.

iReviewNow - Ensuring Accuracy and Fairness
You are almost finished! This is the last page of the authorization. After you have read and signed the following, click "Submit" at the bottom of the page.
INSTANT ABILITY TO REVIEW YOUR REPORT. International Schools Services, Inc. (hereafter "ISS") uses the exclusive patented iReviewNow software, which allows you to review your background (consumer) report to ensure that it is accurate.

How You Benefit:
- You have an opportunity to see the contents of your background report prior to, at the same time, or near the same time as the Company who you authorized to receive your report at iReviewNow.com or by email.
- You have an immediate opportunity to make sure the report is accurate, complete and up to date, and dispute any information you believe to be incomplete or inaccurate. You have an immediate opportunity to provide an explanation for any information contained in the report, especially information about your past, and provide any mitigating circumstances that may assist the Company receiving your background report with any decisions based upon your report.
I agree to the following terms and conditions.

1.       I certify that the information provided on the Background Information Form is my personal identifying information and is accurate and complete.

2.       I agree to review the consumer report about me for accuracy and completeness by exclusively using www.iReviewNow.com (hereafter “iReviewNow) as provided by iReviewNow, LLC. I agree to go to iReviewNow.com to view my report, answer the iReviewNow questions, and dispute any inaccurate or incomplete information.. I agree to contact SecurTest, Inc., the consumer reporting agency and background screening provider, at (800) 445-8001 if I am unable to view my report at iReviewNow.com or have any questions about my report.

3.       I agree and understand that iReviewNow, LLC is a software provider and is neither an employer nor a consumer reporting agency as defined by the Fair Credit Reporting Act. I understand that iReviewNow, LLC is solely providing software through which I may electronically access my report. I understand that the consumer reporting agency who prepared my report is SecurTest, Inc. I understand that iReviewNow nor the consumer reporting agency who procured my report, do not make any employment or other decisions for the Company receiving my report, and the employer is solely responsible for all employment decisions.

4.       By consenting to use iReviewNow, I authorize all legal notices to be provided to me electronically through iReviewNow.com, the email address I have provided understanding that standard text messaging rates apply, as I will receive text messages alerting me to go to iReviewNow.com when my report or notices are ready for my review.

5.       I understand that if I do not view and confirm or dispute my report within five business days from the first text, email message or notice that my report is completed and ready for my review, the Company authorized to review my report may consider a decision based on the contents of my consumer report.

6.       I agree to go to iReviewNow.com to register for automated notification of my report or to view the report when notified.

7.       I have had an opportunity to read or review the Summary of My Rights Under the FCRA and other state notices, other applicable regulations, state and federal laws and consult with legal counsel.

8. ELECTRONIC SIGNATURE AUTHORIZATION: I hereby certify that if I elect to sign electronically that it may be used by the requesting agency, iReviewNow®, SecurTest®, Inc., and court researchers, investigators, or government entities to rely on it as if it were my original handwritten signature.
INVESTIGATIVE CONSUMER AGENCY CONDUCTING INVESTIGATION, unless noted herein:

SecurTest, Inc.

600 Grand Panama Blvd. Ste. 202

Panama City Beach, FL 32407

(800) 445-8001 | www.securtest.com

iReviewNow® – © 2005-2025 – Patented Intellectual Property of Steven C. Millwee and SecurTest, Inc. - ALL RIGHTS RESERVED

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All of the notices required by law are found at SecurTestNotices.pdf. A copy of these notices are attached to the email transmitted to you when you click Submit.
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Disclosure and Authorization

Background Check Participation

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Background screening packages. Read Carefully.

Please Carefully Complete the Following

Contact Information

A Summary of Your Rights Under the Fair Credit Reporting Act

FAIR CREDIT REPORTING ACT NOTICE

Georgia Name-Based Criminal History Record Information (CHRI) Consent/Inquiry Form

iReviewNow - Ensuring Accuracy and Fairness