understand that as part of the employment process, Angels Helpers, Inc. needs to complete a background check on me regarding:

1. Criminal record;
2. Sex and Violent Offenders Record;
3. Employment Verification;
4. Education Verification;
5.License Verification;

6. Motor Vehicle Records;
7. Personal/Professional Reference Verification;
8. Medical Suitability
9. Drugs/Alcohol
o I authorize all federal and state agencies, persons and organizations that may have information relevant to this research to disclose such information to Angels Helpers, Inc. or its authorized agent(s).
o I understand that this authorization is to be part of the written and signed employment application.
o I also understand that I do not have to give authorization for a background check but if I don’t give permission, my employment application will not be processed further.
o I understand that I have specific rights under the federal Fair Credit Reporting Act (FCRA) and may have additional rights under relevant State law.
o I further authorize that a photocopy of this authorization may be considered as valid as the original.
o I hereby certify that all statements on this form are true and correct to the best of my knowledge and belief. I understand that employment with Angels Helpers, Inc. is contingent upon the successful completion of a background check.

Full Name
Telephone No.

Former Name(s)
and Date(s) used
Current Address

Date of Birth
Social Security Number:

Current Driver’s License:

List any other cities, states and dates of residency during last 10 years
From: Month/Year
To: Month/Year
Save Draft
This form is protected by Google reCAPTCHA. Privacy - Terms.
Built using Zapof