We want to know if you have any conditions which we may need to respond to for your safety, or which may risk others.

If you answer "Yes" to any of the following questions, explain your answer at the end. Or, if you prefer, you may decline to answer all or any one of these questions, or you may discuss your answers confidentially with the temple president rather than answering on this form. Answering ‘yes’, or leaving any question unanswered will not necessarily disqualify you.

Please write at least a paragraph (5-7 sentences) for each of the following 3 questions:

As part of the volunteer/employment process, Krishna House (ISKCON Gainesville) will obtain a consumer report, which I understand may include information regarding my character, general reputation, personal characteristics, and mode of living.

During the application process and at any time during the tenure of my volunteering/ employment with the Company, I hereby authorize the Company to procure a consumer report which I understand may include information regarding my character, general reputation, personal characteristics, or mode of living. This report may be compiled with information from courts record repositories, departments of motor vehicles, past or present employers and educational institutions, governmental occupational licensing or registration entities, business or personal references, and any other source required to verify information that I have voluntarily supplied. I understand that I may request a complete and accurate disclosure of the nature and scope of the background verification; to the extent such investigation includes information bearing on my character, general reputation, personal characteristics or mode of living. The information contained in this application is true and correct. I authorize any references or temples listed here to give any information (including opinions) that they may have regarding my character. In consideration of the evaluation of this application by Krishna House (ISKCON of Gainesville). I hereby release any individual, temple, youth organization, charity, employer, reference, or any other person or organization, including record custodians, both collectively and individually, from any and all liability for damages of whatever kind or nature. I understand that my acceptance in any position applied for will be pending completion of the screening process satisfactory to the Company. Should my application be accepted, I agree to be bound by the Policies and Bylaws of the International Society for Krishna Consciousness. I further state that I HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENTS THEREOF AND I SIGN THIS RELEASE AS MY OWN FREE ACT. THIS IS A LEGALLY BINDING AGREEMENT WHICH I HAVE READ AND UNDERSTOOD