Applicant Disclosure and Authorization Form
Authorization for Norris School District to conduct background investigation.
First Name *
Legal Name (Example: Thomas instead of Tom.)
Your answer
Last Name *
Your answer
Social Security Number (9 digits) *
Your answer
BirthDate (MM/DD/YYYY) *
MM
/
DD
/
YYYY
Address *
Your answer
City *
Your answer
State (2 Letter Abbreviation) *
Your answer
Zip Code *
Your answer
Drivers License Number (Required if you have one.)
DMV License Number
Your answer
Purpose for background check. *
By checking the box below, I have read the Applicant Disclosure Form and Acknowledgment, and authorize Norris School District to complete a background investigation. *
NOTE - Disclosure form available in the Central Office or can be viewed here: https://goo.gl/eEf2yS
Required
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