Background Check Authorization Form

Please fill out the form in its entirety. All information provided is handled, stored, and disposed of legally and securely, and is only seen by those who need it for legal purposes.

First, Middle, Last (no initials please)
Other Names Used (optional; separate multiple names with commas)
Current Address / Number + Street
City, State + Zip
Phone Number (include area code)
Email Address
Your Date of Birth
SSN (no spaces)

In connection with your volunteering/employment with Firm Foundation Bible Church (“FFBC”), notice is hereby given that a consumer report and/or investigative consumer report may be obtained from a consumer reporting agency for employment purposes. These reports may contain information about your character, general reputation, personal characteristics and mode of living, whichever are applicable. They may involve personal interviews with sources such as your neighbors, friends or associates. The reports may also contain information about you relating to your criminal history, credit history, driving and/or motor vehicle records, education or employment history, or other background checks.

You have the right, upon written request made within a reasonable time after the receipt of this notice, to request disclosure of the nature and scope of any investigative consumer report prepared by contacting Protect My Ministry, 14499 N Dale Mabry Hwy, Ste 201 South, Tampa, FL 33618 (phone: 1-800-319-5581). For information about Protect My Ministry’s privacy practices, see The scope of this notice and below authorization is not limited to the present and, if you are cleared to serve/hired, will continue throughout the course of your volunteering/employment and allow FFBC to conduct future screenings for retention, promotion or reassignment, as permitted by law and unless revoked by you in writing.


By signing below I hereby authorize the obtaining of consumer reports and/or investigative consumer reports by FFBC at any time after receipt of this authorization and throughout the course of my volunteering/employment, if applicable.

Your Full Name
Today's Date