508 Jay Street, Suite 101, La Crosse, WI 54601
I declare under penalty of perjury that all statements on this form and attachments are true and complete to the best of my knowledge. I understand that false, misleading or incomplete information shall be cause for disqualification.
Note: False statements made under penalty of perjury may also result in criminal prosecution.
I hereby give the Good Fight Community Center, Inc., the right to conduct an investigation of my background. I understand that the investigation may include inquiry into my past employment, education and activities, including but not limited to, criminal background information and driving record. I release from all liability all persons, companies schools, and corporations supplying such information. I release The Good Fight Community Center against any liability, which may result from making such investigation. I understand that any false answers, statements, implications or derogatory information made by me or which is revealed as a result of this background investigation based on information supplied in any application for employment, or other required documents, may be a sufficient cause for denial of volunteer assignment, or dismissal from the program.