Renewals

NORPAC Santas Membership Application
The membership of this society shall consist of individuals who portray Santa Claus, Mrs. Claus, Elf, Reindeer, Santa’s Helper, and other supporting members, with all voices being equal in discussion and agreements.
Membership is open to those who: (a) meet the membership criteria; (b) agree with the club purpose; (c) agree to abide by club bylaws; (d) are in good standing in terms of conduct; (e) pay dues as required; (f) abide by the “Santa Claus Oath;” and (g) provide a valid National background check affidavit with application / renewal.
Annual Family Membership Dues is $35.00 for period of January 1st through December 31st

Application Date *

Applicant Name *

First

Last

Birthday *

Address *

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Primary Phone *

Options Professional Name

Primary Email *

Website Address

Mrs. Claus

• Yes
• No

Are you Mrs. Claus?

Spouse's Name

Elves' Names

Santa's Professional Name *

Background Check Options *

• I will provide a copy of the National Background Check to NORPAC as required.
• I want NORPAC to obtain the National Background Check for me and will pay the $20.00 fee to NORPAC.
• I would like NORPAC to obtain the BGC for me in October so I can use it for this season.

Select the background check option.

Additional Information

Information you would like to share with us.

Payment Details

For office use only. Record payment details here.

Membership/Background Check

Membership

Membership $35.00 USD Background Check $20.00 USD

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Submit Application

Membership Renewal Form

DISCLOSURE AND AUTHORIZATION FORM
TO OBTAIN BACKGROUND CHECK FOR MEMBERSHIP PURPOSES
Please Read Carefully Before Signing the Authorization
DISCLOSURE
In considering you for membership and, if you become a member, NORPAC Santa’s
(“NORPAC”) may request and rely upon one or more background check reports about you
that we obtain from a consumer reporting agency, such as IntelliCorp Records, Inc.
For explanation purposes:

• a “background check report” is a written communication of any information by a
  consumer reporting agency bearing on your character, general reputation, personal
  characteristics, or mode of living which is used or expected to be used or collected in
  whole or in part for the purpose of serving as a factor in making a membership-
  related decision about you. Such information may include, for example, criminal
  history reports, or sex offender history; and Social Security verification.
  Under the Fair Credit Reporting Act (“FCRA”), before NORPAC can obtain a background
  check report about you for membership purposes, we must have your written authorization.
  Before we take adverse action on the basis, in whole or in part, of information in that report,
  you will be provided a copy of that report, the name, address, and telephone number of the
  consumer reporting agency, and a summary of your rights under the FCRA.

Disclosure and Authorization Form

Signature (please type your full name) *

DISCLOSURE AND AUTHORIZATION FORM TO OBTAIN BACKGROUND CHECK FOR MEMBERSHIP PURPOSES AUTHORIZATION I have read and understand the foregoing Disclosure, and authorize NORPAC to obtain and rely upon the background check reports in considering me for membership. By my signature below, I authorize NORPAC to obtain any such reports and to share the information received with any person involved in the membership decision about me. I also agree that this Disclosure and Authorization in original, faxed, photocopied, or electronic (including electronically signed) form will be valid for any background check reports that may be requested about me by or on behalf of NORPAC.

First Name *

Middle Name *

Last Name *

Past of Email

Current Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountry

Addresses for the Past Seven Years *

Include street, city, state, ZIP code, and dates of residence.

Date of Birth *

Other Names Used *

Include maiden name and years used.

Social Security Number *

Email Address *

May be used for official correspondence.

IntelliCorp Records, Inc Permission (Please sign)

I have the right to make a request to IntelliCorp Records, Inc, upon proper identification, to request the nature and substance of all information in its files on me at the time of my request, including sources of information, and the recipients of any reports on me which IntelliCorp Records, Inc has previously furnished within the two-year period preceding my request. I certify that all elements of the personal data I have provided are true, accurate and complete. I understand and agree that any omission, false statement, misleading statement, or answer made by me on my application or any supplements to it and in any interviews will be sufficient grounds for rejection of employment and my discharge after employment

Membership/Background Check

Membership

Background Check $20.00 USD Membership $35.00 USD

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Submit

Membership/Background Check

Membership

Membership $35.00 USD Background Check $20.00 USD