Free background check form 19Free background check form 19Free background check form 19
Download the document to the computer for easy use
There are more pages to preview,Read on

Rochester Institute of Technology (RIT)
Adjunct or Director of Camp/Program with Minors Background Screening Authorization
RETURN FORM TO: HUMAN RESOURCES 5th Floor Eastman Hall
Fax: 585-475-7170
Email: [email protected]

Position Type (check one)
Adjunct

Director of Camp/Programs with Minors

Dept. Name:
Supervisor Name:
Other Dept. Contact Name:
☐ Pre-Employment Criminal Background
Check, Sex Offender Registry, Student
Conduct for current or previous RIT Students
(for all new hire adjunct faculty)

Title:
Ext:
Ext:
Type of Check(s)
☐ Motor Vehicle Record (student workers, staff and faculty employees) only required
when driving is an essential function of the job.
Job duties that require driving:

Last Name:

First Name:

MI:

Current Home Address:
State:

City:

Zip:

Email:

Phone:

Previous Home Address:
City:

State:

Driver’s License Number:

State:

Other names you have used:
*Social Security Number:
Current or Prior RIT Student: ☐ Yes

**Date of Birth:
)

(Years:

Zip:

Name on Licen