BACKGROUND CHECK CONSENT RELEASE FORM
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U-46

LEGAL NAME (as stated on Social Security Card)

First
Middle
Last

DEMOGRAPHIC INFO

Marital Status
Place of Birth
Date of Birth (mm/dd/yyyy)
Sex
Height
Weight
Hair Color
Eye Color
Are you Hispanic/ Latino ?

PERSONAL INFO

Address
City
State
Zip

Phone
(000-000-0000)
Email

SCHOOL