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Pre-Employment Screening Report:

 

Report(s) requested - Highlight all those that are applicable:

 Social security number validation

 Credential Verification

 Education Verification

County felony criminal history check (up to 3 Counties per applicant)

 Driving Record

 Credit Record

 Criminal Records Employment Reference Check

 Personal Reference Check

 Workers' Compensation Claim

 

Person/Company ordering Report:

Name:  

Company:  

Email:  

 

Release Authority required from Candidate:

Click here if you do NOT want a Background Investigation Report run:

  

Click here to release your specific approval to have a Background Investigation Report run:

  

 

If you release your specific approval to have a Background Investigation Report run, please complete the following:

Your full name:  

Last:  

 

First:  

 

Middle:  

Any other names used or known by:  

Current Address:  

Street:  

 

City:  

 

State:  

 

Zip:  

 

County:  

Telephone:  

 

Email:  

 

Previous address (if less than 5 years)

Street:  

 

City:  

 

State:  

 

Zip:  

 

County:  

Date of Birth:  (Month/Date/Year):  

Drivers License:  

Number:  

 

State:  

Social Security Number:  

 

Gender:  

Male:      Female:

Race:  

Black:     White:        Hispanic:     Other:

 

This authorization shall be valid for a period of 3 months:

Please type your full name (in lieu of signature)

Date:  (Month/Date/Year)

 

 

 

Albion has been certified as an Equal Opportunity Employer with Affirmative Action Plan approved by the State of Florida

All services are undertaken in the strictest of confidence and our clients can be assured of a highly discreet and confidential service.

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