Dedicated School Staffing - Background Check Request Form
Background Check Request Form
Organization:
Dedicated School Staffing
Assigned To:
Public User
Show History
To request a copy of your background checks please complete and submit this form. Due to the sensitivity of background checks we will only release them directly to the employee to the email address we have on file. Standard turn around time to process your request is 1-2 business days following the date received. Expired background checks will not be provided.
First Name
First required
Last Name
Last required
Maiden Name
Email
Email required
Date of Birth (XX/XX/XXXX)
Date of Birth required
Requested Document (Check all that apply)
FBI (Ohio)
BCI (Ohio)
PA Criminal History Report
PA Child Abuse Report
PA Federal History Report
Questions or Comments
By signing below, I certify all information is true and correct to the best of my knowledge.
Signature (Type Full Name)
Signing
Signature is required
By typing in your name (your “eSignature”), you accept and consent to be legally bound by this document’s statements, terms and conditions as if this document was signed by you in writing with pen on paper. You agree that no third party or other means of verification is necessary to validate your eSignature and that the lack of such third party or other means of verification will not in any way affect the enforceability of this document.
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History
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Sent To: Public User, On:
12/22/2024 12:51:03 PM Eastern Standard Time
