In conjunction with my application to and/or my participation in a program in the School of Nursing & Health Professions at Northern Kentucky University, I understand that I must submit to and bear the cost of a criminal background check. I understand that Selection.com will conduct this check by obtaining Consumer Reports and/or Investigative Consumer Reports (hereinafter called “Reports”) about me as defined in the Fair Credit Reporting Act (FCRA). These “Reports” may include information concerning my character, academic background, credentials, work habits, work performance, work experience, reasons for work termination, general reputation, personal characteristics or mode of living. This report may also disclose information concerning my employment history, workers’ compensation history, motor vehicle record, education background, civil litigation history and/or criminal record.

I understand that you may rely on any or all of the above referenced information in determining (1) whether to accept me in the particular health professions program for which I’ve applied and/or (2) clinical placement and continuation in a program. If you contemplate making an adverse decision that will affect my acceptance or continuation based, in whole or in part, upon a “Report” obtained from Selection.com, I will be provided with a copy of the “Report” and a written summary of my Consumer Rights under the FCRA.

I have read the above disclosure and I hereby authorize you, Selection.com or its authorized agents, to obtain the above referenced information about me. I also authorize all agencies, bureaus, employers, information service organizations and individuals to provide any of the above referenced knowledge or information they have concerning me. A photocopy or facsimile of this authorization shall be as valid as the original. I agree that any and all disputes with Selection.com arising from this "Report" shall be brought only in state or federal court in the State of Ohio and shall be governed by, and construed in accordance with, the laws of the State of Ohio.