Background Screening Authorization

Background Screening Authorization

Fill out the form below accurately. By completing and submitting this form, the candidate is consenting to a background screening.
CANDIDATE MUST BE ON SITE TO PROVIDE SIGNATURE UPON SUBMISSION
Store Number*
Choose the store that this submission is for.
Store Number*
Choose the store that this submission is for.
Full Legal Name of Candidate (must be name listed on forms of identification)*

First NameLast Name
YesNo
Enter Candidate's legal Middle Name*
If No Middle Name, please type NONE
Date of Birth*

MonthDayYear
Enter the candidate's birthday.
Candidate's Email*

Confirmation EmailEnter the candidate's e-mail address, then again to confirm.
Candidate's Phone Number*
Please enter a valid phone number for the candidate.Format: (000) 000-0000.
YesNo
The Candidate was employed with Fascinations from Date* to Date* .
YesNo
Name of Employee that referred Candidate (Referree):*

First NameLast Name
OOPS! The Social Security Numbers you have entered do not match each other. Please try again.
Social Security Number*
Enter the candidate’s Social Security Number. Do not include hyphens.
Social Security Number Verification*
Enter the candidate’s Social Security Number. Do not include hyphens.
List A Document (Example: U.S/Foreign Passport)List B & List C Documents (Example: Driver's License/State-Issued identification card, Birth Certificate, Social Security card)
Current Home Address*

Current Street Address

Apartment/Suite

CityState

Zip Code
What is the candidate's current rate of pay?*
If the candidate is currently working elsewhere, enter the candidate's current rate of pay here. If the candidate is currently unemployed, put 0.
What position has been offered to the candidate?*
What wage was offered to the candidate for Fascinations?*
Is wage offered higher than base rate for position offered? *
If candidate is offered a wage higher than base rate for your location, please upload their resume, and include any notes that led to your decision on wage offered.

Cancelof
Notes
Candidate's Anticipated Start Date*

MonthDayYear
Date
I hereby authorize Marsoner, Inc. d.b.a. Fascinations to request and receive reports and/or information concerning myself, including but not limited to, references, education, companies, corporations, partnerships, associations, credit bureaus, consumer report agencies, licensing agencies, governmental agencies, previous employers, as well as criminal and disciplinary records. In granting this authorization, I release Marsoner, Inc. d.b.a. Fascinations and those parties providing such information of all liability and responsibility arising out of the release, request, receipt or use of same. I understand that procuring a consumer report may be part of the process of considering my candidacy as an employee. In the event that information from this report is utilized in whole or in part in making an adverse decision with regard to employment with this firm, before making the adverse decision, I will be notified in writing and provided with a copy of the consumer report and a description in writing of my rights under the Federal Fair Credit Reporting Act.

The information contained in this application is correct to the best of my knowledge.
Candidate's Signature*
Today's Date*

MonthDayYear
Store Manager's Signature*
Today's Date*

MonthDayYear
Should be Empty: