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Background Check / Drug Screen Authorization

Background Check

Authorization for Background Check / Drug Screen

The principle purpose for requesting the below information is for conducting job-related background checks and drug screens on persons filling positions with Engaging Solutions, LLC

First Name *

Middle Initial

Last Name *

Please list other alternate names (if any)

Last 4 digits of Social Security Number *

Date of Birth *

mm-dd-yyyy

Electronic Signature for Authorization of Background Check / Drug Screen

Please type your full name to authorize Engaging Solutions to perform a Background Check and Drug Screen.

Date