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Sample Employee Background Check Form


Use this form when documenting your potential employees background before you present an offer for employement.




Corporate Background Check Template



Employee Background Check Form


Note to Hiring Manager: Before making an offer of employment in any position you are required to have a criminal background check completed on your final candidate. Some positions require additional screening. The Employment office will contact you as soon as the background check is complete.


Date: ____/____/______

Hiring Manager Name:

________________________________

Department:

________________________________

Phone:

________________________________

Cell:

________________________________


Hiring Manager Signature:

________________________________


Type of Background Check:

[__] Criminal

[__] Employment

[__] Worker Compensation

[__] Motor Vehicle

[__] Credit Check

[__] Education

Applicant Information:

Position Applied For:

________________________________

Date of Birth: ____/____/______

Last Name:

________________________________

First Name:

________________________________

Middle Name:

________________________________

Phone Number:

________________________________

Email:

________________________________


Social Security: _________________

Drivers License: ________ State: ____

Permanent Address: _______________

City: __________ State: ___ Zip: ____

Length of Time:___________________

Please List Addresses For The Last Seven Years:

Address: _________________________

City: __________ State: ___ Zip: ____

Dates: ___ /____ /___ - ___ /___ /___

Address: _________________________

City: __________ State: ___ Zip: ____

Dates: ___ /____ /___ - ___ /___ /___

Address: _________________________

City: __________ State: ___ Zip: ____

Dates: ___ /____ /___ - ___ /___ /___

I hereby authorize all corporations, former employers, credit agencies, educational institutions, law enforcement agencies, city, state, county, and federal courts, military services, and persons to release information they may have about me to the person or company with which this form has been filed. This releases the above mentioned parties from any liability and responsibility for collecting the above information.



________________________________
Signature of Applicant





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