I understand that, at some point in the selection process, some or all of the information contained in this application could become public and that the facts set forth herein are subject to verification.

I hereby authorize the Union City Board of Education to investigate my background as part of the application process. It is the intent of such authorization to provide full and free access to information for the specific purpose of pursuing a background investigation which may provide pertinent data for the Union City Board of Education to consider in determining my suitability for employment.

I understand that if I am employed by the Union City Board of Education, I will be required to submit to a state and national criminal history record check for a period of 90 days from my date of employment, and I will be required to submit to fingerprinting, at my expense, for purposes of submitting my fingerprints to the Federal Bureau of Investigation for a national criminal history records check. I further understand and agree that if I have been convicted of a crime which has not been disclosed to the Union City Board of Education, the Board may immediately dismiss me.

I authorize any and all law enforcement agencies, current and former employers, and academic institutions to supply any information regarding my background to the Union City Board of Education, and to its agents and employees. In consideration of the Union City Board of Education's review of this employment application, I hereby release the Union City Board of Education, its employees and agents, and all providers of information from any liability resulting from such investigation or furnishing and/or receiving such information.

I have read and understand the above release statements and agree to their contents. I declare under penalties of false statement that I have examined this application and to the best of my knowledge and belief, the information contained therein is true, complete and accurate. I understand that falsification of information on this application form may be grounds for dismissal.

Check Box if you acknowledge and agree with the preceding Release Statements: