ࡱ> 130 Hbjbjvv !e8?SPVooooooooH!oooosoo w.oooϐ”T 0P!!oood U:    New Covenant Christian Community Church Volunteer Authorization For Release of Background Information In connection with my application for volunteer service with New Covenant Christian Community Church (NC4), I authorize NC4 to solicit background information relative to my criminal record history. I understand that NC4 may conduct inquiries into my background that may include criminal records, personal references and other public record reports pertaining to me. I authorize without any reservation, any person, agency, or other entity contacted by NC4 or their agent for purposes of obtaining background report information, to furnish the above mentioned information. I release NC4, their respective employees or agent and employees and all persons, agencies and entities providing information or reports about me from any and all liability arising out of furnishing any such information or reports. Requested by: NC4 PLEASE PRINT__ Last Name____________________________ First Name_____________________Date of Birth_________ City of Birth___________________________County_________________________ State_______________ AKA/ Maiden Name__________________________________________ Social Security No.____________ Please note: If your address is a rural route, or post office box, we must have City & County to which mail was delivered. Current Address___________________________City______________________Co.________ St.___ Zip__________ How long at this address? (Months/Years) ________ Previous Address___________________________City______________________Co.________ St.____Zip__________ How long at this address? (Months/Years) __________ Previous Address___________________________City______________________Co.________ St.____Zip__________ How long at this address? (Months/Years) __________ SIGNATURE ________________________________________________________ DATE ________________ Thank you for applying to help in the ministry at New Covenant Christian Community Rev. 2/06  !"FO  4 B 0>iCDǻukkkf_ThB5CJOJQJ h|!hB hB5hBCJOJQJhB5CJOJQJhB5>*CJOJQJh jhB5CJOJQJhB5>*OJQJhB5OJQJhBOJQJhBh7hB5CJaJh7hB5CJ\aJh7h+25CJaJh7h75CJaJh75CJaJh15CJaJ F    w x y 3 4 B $a$#$d!%d!&d!'d N!O!P!Q $a$gdBgdB HIJTO8CDE$a$gdB$a$$a$$a$gdBEFGH$a$gdBDGH h|!hBhB0 / =!"#$%666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH @`@ NormalOJQJ_HmH sH tH LL  Heading 1$$@&a$5CJOJQJ\DA D Default Paragraph FontViV  Table Normal :V 44 la (k (No List L%L Envelope Return5:OJQJkH44 wfxRecipient.. wfxFaxNum*"* wfxDate*2* wfxTime0B0 wfxCompany0R0 wfxSubject4@b4 Header  !4 @r4 Footer  !PK!K[Content_Types].xmlj0Eжr(΢]yl#!MB;BQޏaLSWyҟ^@ Lz]__CdR{`L=r85v&mQ뉑8ICX=H"Z=&JCjwA`.Â?U~YkG/̷x3%o3t\&@w!H'"v0PK!֧6 _rels/.relsj0 }Q%v/C/}(h"O = C?hv=Ʌ%[xp{۵_Pѣ<1H0ORBdJE4b$q_6LR7`0̞O,En7Lib/SeеPK!kytheme/theme/themeManager.xml M @}w7c(EbˮCAǠҟ7՛K Y, e.|,H,lxɴIsQ}#Ր ֵ+!,^$j=GW)E+& 8PK!\theme/theme/theme1.xmlYOoE#F{o'NDuر i-q;N3' G$$DAč*iEP~wq4;{o?g^;N:$BR64Mvsi-@R4Œ mUb V*XX! cyg$w.Q "@oWL8*Bycjđ0蠦r,[LC9VbX*x_yuoBL͐u_. DKfN1엓:+ۥ~`jn[Zp֖zg,tV@bW/Oټl6Ws[R?S֒7 _כ[֪7 _w]ŌShN'^Bxk_[dC]zOլ\K=.:@MgdCf/o\ycB95B24S CEL|gO'sקo>W=n#p̰ZN|ӪV:8z1f؃k;ڇcp7#z8]Y / \{t\}}spķ=ʠoRVL3N(B<|ݥuK>P.EMLhɦM .co;əmr"*0#̡=6Kր0i1;$P0!YݩjbiXJB5IgAФ޲a6{P g֢)҉-Ìq8RmcWyXg/u]6Q_Ê5H Z2PU]Ǽ"GGFbCSOD%,p 6ޚwq̲R_gJSbj9)ed(w:/ak;6jAq11_xzG~F<:ɮ>O&kNa4dht\?J&l O٠NRpwhpse)tp)af] 27n}mk]\S,+a2g^Az )˙>E G鿰L7)'PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-!K[Content_Types].xmlPK-!֧6 1_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!\theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] HFwxy34BHIJTO8CDEFIX%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^X%^y"y"y"y"y"y"=y"y"y"=y"y"y"y"y"y"y"y"y"y"y"y"=S=dddgDH  EH :DFIFIBFI@HP@UnknownGTimes New Roman5Symbol3 ArialKBookman Old StyleSArial Rounded MT Bold"hTFT # -Yr4d3H(?70NC4 Background Check FormTony Piergiovanni Philip Smith Oh+'0 ( H T ` lx'NC4 Background Check FormTony Piergiovanni Normal.dotmPhilip Smith9Microsoft Word 12.1.2@e@J}.@|.@T# ՜.+,0 hp  'ADSI  NC4 Background Check Form Title !"#$%&')*+,-./2Root Entry FH”T41Table!WordDocument!SummaryInformation( DocumentSummaryInformation8(CompObj` F Microsoft Word 97-2004 DocumentNB6WWord.Document.8