
Please Print out the page below, fill out, and return
Complete Form and Sign
Fax, Email, or Mail back to Funland Marketing & Referrals
Once we recieve this form signed, we will process your application
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FAX, EMAIL, OR MAIL THIS FORM BACK TO:
(Must have your signature to be valid!!!)
Funland Referrals, ID dept.
PO Box 5281
Fayetteville, AR 72714
Fax: 501.421.0366
Email: Michael@FunlandMarketing.com
AUTHORIZATION AND RELEASE TO OBTAIN INFORMATION Under the provisions of the Fair Credit Reporting Act, 15 USC, Section 1681 et seq., the Americans with Disabilities Act and all applicable federal, state, and local laws, I hereby authorize and permit to obtain a consumer report and/or an investigative consumer report which may include the following: 1. My employment records; 2. Records concerning any driving, criminal history, credit history, civil record, workers’ compensation (post-offer only) and drug testing; 3. (For truck drivers only) In accordance with the Department of Transportation Motor Carrier Safety Regulations, Section 382.413, information concerning alcohol and controlled substances for the past 3 years; 4. Verification of my academic and/or professional credentials; and information and/or copies of documents from any military service records. I understand that an “investigative consumer report” may include information as to my character, general reputation, personal characteristics, and mode of living, which may be obtained by interviews with individuals with whom I am acquainted or who may have knowledge concerning any such items of information. I agree that a copy of this authorization has the same effect as an original. I hereby release and hold harmless any person, firm, or entity that discloses matters in accordance with this authorization, as well as from liability that might otherwise result from the request for use of and/or disclosure of any or all of the foregoing information. I understand and acknowledge that under provision of the Fair Credit Reporting Act I may request a copy of any consumer report from the consumer reporting agency that compiled the report, after I have provided proper identification. I hereby authorize to obtain and prepare an investigative consumer report as set forth above, as part of its investigation of my employment application. This authorization shall remain in effect over the course of my employment. Reports may be ordered periodically during the course of my employment. NOTE: Except for those states where an annual release is required, i.e. California (CALIFORNIA – Continuing consent concept is inapplicable and a separate authorization must be requested each time a report is ordered. - CA Civ. Code 1786.22)
I understand that once I am employed, transportation will be provided. Getting to the jobsite is my responsibility if referred by Funland Marketing & Referrals, LLC. If advanced monies, bus, air, or any other means to get to the jobsite to start the job, I understand that I am responsible for paying back this fare in full.
I understand that I am being referred by Funland Marketing & Referrals. The employee/employer relationship will be between the referred to company (carnival) and myself. Any and all actions pertaining to an employee/employer relationship shall be between said parties and will hold harmless Funland Marketing & Referrals, LLC from any and all lawsuits.
(Please print clearly)
| Date: Social Security Number: |
| Full Name: |
| Address: City: St: Zip: |
| DOB mm/dd/yyyy: |
| Drivers License #: State: |
| Signature: |
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