In connection with my application to become a volunteer with Special Olympics Northern California, Inc. (“SONC”), I understand that, prior to or at any time after any acceptance of my volunteer application, a Consumer Report or Investigative Consumer Report about me (the “Report”) may be requested by SONC for volunteer participation purposes from a consumer reporting agency (“Reporting Agency”). I understand that the information in the Report will be obtained by accessing public records from various local, state, and federal agencies to the extent permitted by law, including but not limited to my motor vehicle operation history and criminal history. I understand that the Report may include information as to my character, general reputation, personal characteristics, and/or mode of living. I also understand that information sought will include a search of the state and/or federal Sexual Offender Identification Line(s) or Registry(ies).
I HEREBY VOLUNTARILY AND KNOWINGLY AUTHORIZE REPORTING AGENCY TO SEEK INFORMATION ABOUT ME ON BEHALF OF SONC, AND AUTHORIZE SONC TO PROCURE AND USE THE INFORMATION PROVIDED BY REPORTING AGENCY ABOUT ME (INCLUDING ANY INFORMATION OBTAINED FROM THE SEXUAL OFFENDER IDENTIFICATION LINE(S) OR REGISTRY(IES)) IN CONNECTION WITH MY SONC VOLUNTEER APPLICATION. I UNDERSTAND THAT SONC MAY USE THIS INFORMATION FOR VOLUNTEER PARTICIPATION PURPOSES, INCLUDING BUT NOT LIMITED TO ACCEPTANCE OR DENIAL OF MY SONC VOLUNTEER APPLICATION, MY SONC VOLUNTEER ASSIGNMENT OR REASSIGNMENT, AND ANY TERMINATION OF MY SONC VOLUNTEER STATUS. I ALSO HEREBY AUTHORIZE ANY ADMINISTRATOR, LAW ENFORCEMENT AGENCY, STATE AGENCY, LOCAL AGENCY, FEDERAL AGENCY, AND/OR OTHER PERSONS TO GIVE RECORDS OR INFORMATION THEY MAY HAVE CONCERNING MY MOTOR VEHICLE/DRIVING RECORD HISTORY, CRIMINAL HISTORY, OR ANY OTHER INFORMATION ABOUT ME AS REQUESTED BY REPORTING AGENCY.
In accordance with the federal Fair Credit Reporting Act, the California Consumer Credit Reporting Agencies Act, and the California Investigative Consumer Reporting Agencies Act, I understand that I have the right to request a complete and accurate disclosure of the nature and scope of the investigation requested for the Report. Further, I am entitled to know if my SONC volunteer application is denied because of information obtained by Reporting Agency. If so, I will be so advised in writing and be given the name and address of the Reporting Agency, including its toll free number, a statement that the action was based in whole or in part on information contained in the Report, and written notice that I have the right (i) if I request, to obtain within sixty days a free copy of the Report from the Reporting Agency; and (ii) to dispute the accuracy or completeness of any information in the Report furnished by the Reporting Agency. I further understand that upon my request with reasonable notice, Reporting Agency will supply me with investigative information in my file during normal business hours in person or upon written request, by mail or telephone as permitted by law. I also understand that Reporting Agency is a consumer Reporting Agency and it is Reporting Agency‘s policy to not be involved in or make decisions or recommendations concerning volunteers for SONC. I also understand that Reporting Agency does not sell or otherwise provide any of the information found in its background investigations to any other party. I further understand that any Report requested will be used strictly for permissible purposes. In addition, any assignment (or reassignment) as a volunteer for SONC will be conditioned on the receipt of satisfactory information as determined by SONC, and that to be considered for assignment as a SONC volunteer, I must authorize the procurement of the Report(s) and sign this Disclosure & Authorization to Obtain Information document. A photographic or faxed copy of this Disclosure & Authorization to Obtain Information document shall be as valid as the original.
Leave a Reply