Application form

Consent and Authorization:

It has been explained to me that certain client facilities where I may be placed to provide temporary staffing require to undergo a criminal history record check (CHRC) prior to my placement thereat even though I may be licensed under the provisions of the education law or such other licensing body. By signing where indicated below, I hereby consent to and authorize Loyalty Staffing Solutions to conduct such a criminal history check (CHRC) and to provide a copy of the results to the client facility in compliance with their internal policies, procedures and guidelines.

 

By signing where indicated below, I agree to hold the company, its owners, directors, agents, and contractors, harmless from any alleged violation of my right of privacy or otherwise relative to the search of the disclosure of the results.

 

I hereby authorize the company, without reservation, to provide the consent and authorization to the People Facts 1435 Chesterfield Lane Maumee, OH 43537 (#800-662-0130) or other organization to conduct the search.

Your Signature

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Loyalty Staffing ©2020.

T: +1 (844) 991-9897  A:1810 Carriage Lane, Palm Springs, California. 92262