Please type something in every blank space - use n/a if it doesn't apply to you. Thank you!
Please list the names and contact information of two people who are not related to you, who have known you personally for at least a year, and have a definite knowledge of your character.
CHURCH BACKGROUND/PASTORAL REFERENCE
Please list a Pastor or Ministerial Supervisor from any of the churches you have attended within the past three years.
BACKGROUND SCREENING CONSENT
I, the undersigned, give my authorization of Covenant Centre International representatives - herinafter referred to as CCI - to verify the information on this form. CCI may contact my references and appropriate government agencies as deemed necessary in order to verify my suitability as a student for LIFE SCHOOL. I am willing to request and submit to CCI background reports on myself from the Florida Department of Law Enforcement or other investigative agency whether public or private.
The information contained in this application is correct to the best of my knowledge. I authorize any references or churches listed in this application to give you any information that they may have regarding my character and fitness for LIFE SCHOOL. In consideration of the receipt and evaluation of this application by CCI, I hereby release any individual, church, children's organization, charity, employer, reference or any other person or organization, including record custodians, both collectively and individually, from any and all liability for damages of whatever kind or nature that may at any time result to me, my heirs, or family, because of compliance or any attempts to comply with this authorization. I waive any right that I may have to inspect any information provided about me by any person or organization identified by me in this application. Should my application be accepted, I agree to be held to the constitution, statement of faith and policies of CCI and refrain from conduct unbecoming to Christ in performance of my services on behalf of CCI. If I violate these guidelines, I understand that my student status may be terminated. By signing this application, I state that all information given about myself is true.
I further state that I have carefully read the foregoing release and know the contents thereof, and I sign this release as my own act.
Call the Church Office to give your Social Security Number.
Call the Church Office to give your Drivers License Number.
Please type something in every blank space - use n/a if it doesn't apply to you. The Application may not "Submit" if something is left blank.