Page 1

Fuel International Registration

Enter your name as it appears on your passport or birth certificate




















If you are under 18 please complete the following




Pastor/Youth Pastor Info








Page 2 - Complete if you are 18 or over

Background Check Information
Background Verification Disclosure with Credit
As a part of the employment and/or associative relationship process, Fuel International and its agents and employees may make investigative inquiries on my background and personal references. The Fair Credit Reporting Act as amended by the Consumer Reporting Act of 1996 requires that we advise you, the consumer, that a report may be made which may include, but not limited to information pertaining to your credit standing and capacity, character, reputation, personal traits, mode of living, past and present employers, reasons for termination, and other descriptive qualities. It is understood that the willful suppression or intentional misrepresentation of any fact supplied by myself to Fuel International will be considered bad faith at the discretion of Fuel International and could terminate the proposed employment and/or associative relationship with Fuel International. Upon written request, information as to the nature and scope of the report will be provided (if one is made) if employment and/or associative relationships are denied due to information obtained therein.






I hereby authorize any officer, representative, contractor, or vendor of Fuel international bearing this authorization or copy thereof to conduct background investigations including but not limited to a national cross reference of 50 states showing actual addresses, obtaining a consumer credit report, any information regarding my driving history and records, criminal history, and community standing. The report may include interviews with my neighbors, friends, associates, past and present employers, and records of banking, financial statements, professional worker's compensation claims, military history, and civil and insurance claims. In compliance with the Americans with Disabilities Act, I understand that the information is for the official use of Fuel international and its officers, representatives, contractors, and vendors. Consent is granted for Fuel international and its officers, representatives, contractors, or vendors to furnish such information as described above to third parties in the course of fulfilling their official responsibilities. Please furnish the bearer with any information you have about me.

Need assistance with this form?