Please complete the following form to request a Background Check for a potential new employee. By submitting this information the Office of Human Resources will contact the potential employee directly to begin the process. The hiring authority will be contacted upon receipt of results.

Please be sure to complete ALL fields. Incomplete forms may result in your request being delayed.

Person Completing the form:
Name:
Department:
Phone Number:
Email:
Banner Index to Charge:
Ala Carte Options:
Potential Employee :
Full Name:
Department:
Email Address:
Position Title:
Appointment Type:
Phone Number:
Search Number
(if applicable):
 * If search was not conducted, provide explanation in comment box below.

Comments:
  **

**By pressing 'submit', an email with the above information will be sent to The Office of Human Resources.

Please contact The Office of Human Resources at 406-994-3651 with questions.

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