(Please read and sign in the space provided above. Your written authorization is necessary for completion of the application process.)
 
By signing this application, I hereby authorize Movement of Youth to investigate my background and qualifications for purposes of evaluating whether I am qualified to become a mentor. I understand that Movement of Youth will utilize an outside firm or firms to assist it in checking such information, and I specifically authorize such an investigation by information services and outside entities of the company's choice. I also understand that I may withhold my permission and that in such a case, no investigation will be done, and my application will not be processed further.