Read this form before completing and signing it. If you disagree with any intended uses of the information or are unwilling to have this information collected, used, and stored as set out below, do not complete this form. This profile is for the use of JDI. The information provided will be used for determining your suitability for service as a Certified Adult Volunteer (CAV). The information you provide will be released to one or more third parties, including private investigating agencies and law enforcement agencies, for the purpose of conducting background inquiries, including criminal history checks. The original form will be retained in the office of the Executive Manager of JDI. This form shall be RECEIVED by the Supreme office NO LATER than 6 months after your date of attendance at a Certified Adult Volunteer (CAV) class in order to be considered valid for processing. There are NO EXCEPTIONS to this deadline.
I freely and voluntarily provide the information submitted on this form. I give my permission to Job’s Daughters International (JDI) to gather further information about me in order to determine my suitability for service as a Certified Adult Volunteer (CAV) with JDI. I understand that the safety and best interests of the members of JDI are the paramount considerations in determining my suitability. I authorize JDI to provide the information I have submitted to various individuals, entities, and agencies for the purposes stated in this form. I understand and agree that said individuals, entities, or agencies may review, inquire into, and provide reports regarding my background to JDI. I understand that these reports may include, but are not limited to: criminal records, educational reports, employment reports, and driver’s license records. In connection with my request to be allowed to serve as a CAV of JDI, I request and authorize all individuals, corporations, current and former employers, educational institutions, law enforcement agencies, city, state, county, and federal courts, federal agencies, and military services to release information they may have about me to the person or entity to whom this form has been provided by JDI. I understand that my information connected to this application will be kept in secure storage at SGC headquarters in Papillion, Nebraska. By signing this form, I specifically and wholly release, hold harmless, and agree to indemnify Job’s Daughters International, Supreme Guardian Council, its subordinate organizations, and all of its and their members, officers, employees, agents, contractors, and volunteers from any and all liability to me, my heirs, survivors, successors in interest, assigns, or anyone claiming through me, in connection with the collection, storage, release, or use of, on behalf of JDI, any information provided by me or derived through any inquiry, investigation, or review of records arising from my submission of this form and my request to serve as a CAV with JDI. I promise that, as a CAV of JDI, I will protect the safety of its members, act only in their best interests, comply with the governing documents of JDI, and that I will obey the laws of my city, state, and nation. I understand and agree that the cost of conducting the background investigation is included in the application fee. I agree to pay that cost prior to the initiation of the investigation, and I understand that no investigation will begin until I have made that payment. I certify that the information provided herein is complete and accurate. I will immediately notify JDI of any changes in that information. I understand that I am not entitled to a position as an officer or volunteer in JDI, and that service in those capacities is a privilege, not a right.