Processed by
AS REQUIRED BY LOUISIANA STATE LAW
Authorization to Disclose Criminal History Record Information
I understand that a thorough investigation will be conducted from the files that are maintained with the Louisiana Department of Public Safety and Corrections, Office of State Police.
By signing and submitting this background request I understand and agree to the following:
By my signature below, I authorize such an investigation and release of all criminal record information, which may confirm or deny my eligibility for employment/enrollment with the facility named above. I waive such legal rights and release all persons from any liabilities in connection with furnishing such information to the above facility. I understand that it is a crime to provide false information concerning a criminal history check to an employer.
Student Signature: