Goodwill Industries of Fort Worth
Authorization and Consent for Release of
Criminal Background Information & Drug Screening

I, the undersigned applicant, do hereby certify the information provided by me for the purpose of training is true and complete to the best of my knowledge.  I understand that any false statements or failure to pass required drug screening may be cause for non-enrollment or termination from the program.

I authorize Public Data/Texas Department of Public Safety/Trans Union/Insurance Information Exchange/Goodwill Industries of Fort Worth, and any of its agents/designated Company Personnel, to disclose orally and in writing the results of this verification/screening process.

I have read and understood this release and consent, and I authorize the background verification.  I authorize persons, current and former employers, and other organizations and Agencies, to provide Public Data/Texas Department of Public Safety/Trans Union/Insurance Information Exchange/Goodwill Industries of Fort Worth with all information that may be requested.

I understand that, upon written request within a reasonable period of time, I am entitled to additional information concerning the nature and scope of this investigation.  I understand that pursuant to the Fair Credit Reporting Act (FCRA), I have the right to know if adverse action is being considered against me as a result of information contained in this report, that I have the right to a copy of this report prior to any adverse action taken against me and to dispute the accuracy of any information in this report by contacting the consumer reporting agency, Public Data/Texas Department of Public Safety/Trans Union/Insurance Information Exchange/Goodwill Industries of Fort Worth, whose address and telephone number are listed at the bottom of this form.  I understand that I may have additional rights under State law which I may determine by contacting my State or local consumer protection agency. I hereby release Goodwill Industries of Fort Worth/NTI, Public Data, Texas Department of Public Safety, Trans Union, Insurance Information Exchange, their officers, agents, their associates, and employees, from any liability arising from the preparation of this report or investigations relating thereto.

 

Criminal Background Check
Address
Provide a home address for each state (other than Texas) in which you have lived over the past 7 years:
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Address
Provide a home address for each state (other than Texas) in which you have lived over the past 7 years:
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State/Province
Zip/Postal
Country

Goodwill Industries of Fort Worth
Annual Statistical Report – Client Intake Form

I understand that the completion of this form is voluntary and is used to collect statistics so Goodwill Industries of Fort Worth can seek future funding and report to Goodwill International annually.

ASR Client Registration
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Employment Interests & History

Employment Interests & History

Employment History (start with the most recent employer)

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Education Interests & History

Education Interests & History
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Education History (start with the most recent education)

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