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If an organization you are affiliated with (such as your employer) has undertaken a criminal record check on your record in the last 18 months, you do not need to complete this form. Instead, the organization that completed the check need only confirm that you passed a criminal records check by emailing the NET Coordinator at firstname.lastname@example.org.
If you have a license or permit that requires a criminal records check (such as teaching license or concealed handgun permit), you may scan a copy of that document and email it in order to fulfill the criminal records check requirement.
Informed Consent/Release and Hold Harmless Waiver ensuring confidentiality of Criminal Records Check
I understand that I am authorizing an investigation into aspects of my personal life to determine my fitness in relation to my volunteer service with PBEM. This investigation may include contacting persons or organizations that have information relating to my suitability.
I further recognize that although some of the information contained in this check is a matter of public record, or otherwise would be accessible to me, this information could be interwoven with other confidential information to which I would otherwise not be privy.
Therefore, I exonerate, release and discharge the City of Portland, the Portland Bureau of Emergency Management, its officers, or assigns, now and in the future, from any claim or damages, whether in law or in equity, on behalf of myself, my heirs, agents, or assigns, for their refusal to make available any and all information contained in this investigation, including but not limited to the identity of any person or organization who may have supplied information in the course of this investigation, as well as the substance of any such information supplied, even where such information has been the basis for my disqualification.