By providing your signature, you are consenting and agreeing to abide by the
rules and regulations of the Pewaukee School District Volunteer and Campus Programs.
Serving as a volunteer may require you to provide your United States Social
Security number in order to perform a criminal background check. Your Social
Security number will only be used for this purpose and is not retained in our
system. Enter your Social Security number as digits only (no dashes or spaces).
DISCLOSURE OF INTENT TO OBTAIN BACKGROUND REPORTS
For volunteer purposes, the Pewaukee School District, and/or JD
Palatine, LLC. may obtain consumer reports or investigative consumer reports,
in connection with your volunteer application or from time to time during a volunteering
period in accordance with applicable law. Consumer reports include record
checks conducted by consumer reporting agencies and may include driving records
and/or criminal records. You may make a written request for a summary of
consumer rights and a disclosure of the nature and scope of an
investigation. A disclosure of the nature and scope of such investigation
is provided below.
DISCLOSURE OF NATURE AND SCOPE OF INVESTIGATION FOR INVESTIGATIVE
CONSUMER REPORT
In the event we request an investigative consumer report in connection with
your volunteer application or during your volunteering period, a consumer
reporting agency will prepare an investigative consumer report based on the investigation.
The agency will also conduct a records check of driving and criminal
records. Such a report will be obtained from JD Palatine, LLC. I agree
I have received and/or reviewed a summary of my rights under the Fair Credit
Reporting Act.
AUTHORIZATION:
I
authorize the Pewaukee School District and JD Palatine, LLC to obtain consumer
reports and/or investigative consumer reports regarding me from time to time
for volunteer purposes. Additionally, to the extent that JD Palatine, LLC
obtains such reports, I consent to their release to the Pewaukee School
District. In compliance with the Fair Credit Reporting Act, as amended by the
Consumer Credit Reporting Reform Act of 2003, JD Palatine, LLC needs my authorization
to obtain such a report.
Please
acknowledge the following attachment prior to signing.
https://s3.amazonaws.com/files.consumerfinance.gov/f/201504_cfpb_summary_your-rights-under-fcra.pdf