Total Check

Elkhorn Athletic Association
Volunteer Background Check Form

Please read all instructions before completing this form!

Please contact One Source at 800.608.3645 if additional assistance is needed.

Enter the following data:
1. APPLICANT NAME: Enter First, Middle and Last Name. (Full Legal Name)
2. CURRENT ADDRESS: Enter complete Current Address.
3. SSN: Enter Social Security Number. Do not enter hyphens or dashes. EXAMPLE: 111223333
4. DOB: Enter Date of Birth. Do not enter hyphens or dashes. EXAMPLE: 12/10/1970 or 12101970
5. APPLICANT PHONE NUMBER: Enter a phone number the applicant can be reached at between 8 am and 5 pm.
6. APPLICANT EMAIL ADDRESS: Enter an email address the applicant can be reached at between 8am and 5pm.
7. DRIVERS LICENSE and ISSUING STATE: Enter a drivers license number and issuing state.
8. DEPARTMENT: Do not enter information in this field.

The following information may be required by law enforcement agencies, local, state or federal governmental agencies or similar public bodies for positive identification purposes when checking public records. I understand that this information is confidential and will only be used for background screening purposes.

According to the Fair Credit Reporting Act you are to be provided with a copy of your rights according to the FCRA. Please click here for the Summary of Consumer Rights According to the FCRA.

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First Name
Middle Name
Last Name
Your Email Address
Daytime Phone Number
Full Street Address
Zip Code
Social Security Number
Birth Date (DOB)   MMDDYYYY -or- M/D/YYYY
Driver's License #
Issuing State
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