Understanding and Authorization
I certify that all the answers on the application and any attachments are true and complete
to the best of my knowledge. I also certify that I have not withheld any pertinent information.
I agree that in the course of considering my application, you may inquire to verify information
considering my background.
I specifically authorize you to investigate all statements in this application.
I authorize educational institutions, employers and references listed above to give you
any and all information concerning my education, employment, and fitness to work with
children and young people.
I further agree to release and hold harmless the Boys & Girls Clubs of Rockford, institutions and references listed above and
any law enforcement agency, from all liability and any damage that may result from furnishing this information to you.