You have requested the opportunity to complete a background questionnaire as part of the Baptist College of Health Sciences Admissions enrollment process. Before you may begin the background questionnaire, you will need to electronically sign an Authorization Form ("Authorization Form"). This Authorization Form will allow our background agency, Data Facts, Inc.,, to verify the information that you provide and conduct a background check on you.

The process of signing the Authorization Form will be conducted electronically to make it easier for you. To ensure that your Authorization Form is not altered after its submission, Data Facts, Inc. employs special technology called a SHA-1 message digest algorithm to take a digital "fingerprint" of your application data and Authorization Form. It is virtually infeasible to produce two messages having the same message digest. Once we have your information stored in this manner, the data cannot be altered without also affecting the message digest. Any changes or tampering with your Authorization Form data are thus made apparent to Data Facts, Inc.. Please see FIPS 180-1 for a more detailed explanation.

To ensure that a signature is unique, and to safeguard applicants against unauthorized use of their name, your IP address has been recorded and will be stored along with your electronic signature. In addition, please note that Data Facts, Inc. requires applicants wishing to submit their Authorization Form electronically to include their social security number. This information will be sent over a secure website and will be encrypted.

You will have the opportunity to print the completed Authorization Form upon completion.

Note that if you do not wish to complete the Authorization Form electronically, you may print it out and send it to Data Facts, Inc..

(type full name), consent to signing this form electronically. I understand that Data Facts uses computer technology called SHA-1 message digest algorithm to ensure that my Authorization Form is not altered after its submission. I agree to allow Data Fac