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Please state here the board or commission or general subject area in which you have interest.
Do not include motor vehicle offenses involving a fine of $200 or less.
I certify and affirm that I have carefully reviewed all of the information I have supplied in this Biographical Information Form, and that it is true and correct.
2.-------------I authorize Caroline County to solicit information regarding my character, general reputation, previous employment, and similar background information, and to contact any previous employers and references I have listed on this Form. I authorize employers and references provided in this Form to furnish Caroline County with information they may have regarding my character, general reputation, previous employment, and similar background information. In consideration of Caroline County’s willingness to consider me for appointment to the Caroline County Board of Social Services and to evaluate my credentials against other applicants, and the willingness of my previous employers and references to supply information which is necessary to that process, I release, discharge, and hold harmless Caroline County from any liability whatsoever in connection with the furnishing or obtaining of employment information, or arising out of the proceedings of this Form and consideration of my candidacy for the position I have ed for.
3.-------------I understand that I may be subject to a criminal background check and authorize Caroline County to perform a criminal background check, including, but not limited to, criminal record review and review of my driving record.
4.-------------I specifically acknowledge that:
- If, during the selection process, any information I have supplied on this Form is found to be incorrect or incomplete, I may be subject to disqualification from further consideration as an applicant for the Caroline County Board of Social Services for furnishing false information.
- If, after I have been appointed to the Caroline County Board of Social Services, any information I have supplied is found to be incorrect or incomplete, I may be removed from the Board for furnishing false information.
5.-------------I fully understood the provisions of this Applicant Certification and Authorization when I read them, or they were fully explained to me by the Caroline County Commissioners Office.
This field is not part of the form submission.
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