Get Eec Background Record Check:reviewer Request

Completing the EEC Background Record Check: Reviewer Request form is essential for anyone involved in the hiring process within licensed programs. This guide provides clear, step-by-step instructions to help you successfully fill out the form online.

Follow the steps to complete your form effortlessly.

1. Click the ‘Get Form’ button to access the EEC Background Record Check: Reviewer Request form and open it in your online editor.
2. Indicate your role by checking the appropriate box to clarify whether you are a necessary participant in the hiring decision or if you will only have access to background check information.
3. Fill in your full name as required, including last name, first name, middle name, and any maiden or other surnames.
4. Provide your date of birth in the format MM/DD/YY and specify your place of birth.
5. Enter your social security number in the designated field.
6. List your past seven years of residence by entering the number and street, city, state, and zip code. Ensure to include current or present address as well.
7. If applicable, list other states where you have resided.
8. Respond to the criminal offense question by checking 'yes' or 'no'. If you check ‘yes’, provide details regarding your convictions and their dates.
9. Answer the questions regarding allegations of abuse or neglect, answering 'yes' or 'no'. If you answer 'yes', provide the requested details.
10. Sign and date the form where indicated to confirm your consent for EEC review of your background records.
11. Complete the program information section, including the program name, address, and phone number.
12. Carefully read and sign the non-disclosure agreement and the statement of CORI certification compliance on the reverse side of the form.
13. After reviewing all information for accuracy, save changes, download, print, or share the form as needed.

Complete your EEC Background Record Check: Reviewer Request form online today.