Consent Form for Conducting Background Check, Drug Screening and Driver’s License:
There is a possibility that your eligibility for independent contractor relationship may be determined, entirely or partially, by Wifi America. Using data from a report supplied by its agent(s). Pursuant to Section 609 of the Fair Credit Reporting Act, you may be entitled to a copy of this report
Consent of Applicant: It is my understanding that Wifi America will recruit a third party to conduct my background check and will verify all or part of the information provided by me to United Sales. I authorize the release of such information as may be necessary to verify the information I have provided. I agree that Wifi America may conduct this verification and I also understand that this verification may include any inquiry into my credit history, motor vehicle driving record, criminal and civil records, previous employers, educational institution (degree, GPA and attendance records), as well as other public record information. I release and hold Wifi America harmless, from all liability. I understand that if I am able to begin work prior to all background information being obtained, the work is conditional upon satisfactory return of information.
FAIR CREDIT REPORTING ACT DISCLOSURE & AUTHORIZATION
I understand that Wifi America may have background checks conducted about me and my past (such as employment reference checks, personal reference checks, criminal record checks, motor vehicle background checks, or education verification when making decisions about my employment (such as hiring, assignment, transfer, promotion, or dismissal decisions). I understand that Wifi America may hire credit reporting agencies* or other service providers covered by the federal Fair Credit Reporting Act (“FCRA”), 15 U.S.C. § 1681 and Federal Trade Commission regulations contained in 16 C.F.R. Part 601, to conduct such background checks and to report the results of such checks to Wifi America. I acknowledge that I received this Disclosure and that I voluntarily and fully authorize Wifi America to obtain reports relating to the background checks described above from credit reporting agencies or other service providers, and to use such reports when making decisions about my employment (such as hiring, assignment, transfer, promotion, or dismissal decisions). I also understand that Wifi America enters into representative sales relationships with various corporations and may be required to disclose the results of my background checks to corporate representatives as a condition of obtaining business opportunities from those corporations. I voluntarily and fully authorize Wifi America to disclose the results of any and all background checks about me to such corporate representatives for this business employment purpose. By signing below, I affirm that I have not been convicted (whether by guilty plea, nolo contendere plea, a finding of guilt, or otherwise) of a felony or misdemeanor.
I voluntarily agree to report to Wifi America any arrests or convictions for any misdemeanor or felony that may occur after the date of this Disclosure and Authorization, within five days of any such arrest or conviction.
By signing below, I also affirm that I do not currently abuse illegal drugs, controlled substances, prescription medication, over-the-counter medications or any other substances.