ATHLETIC/ECA COACH Background Check

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PLEASE NOTE: Coach Background Checks are required by Eastern Hancock to be renewed every 5 years. (If you have a Coach BGC on file, you do NOT need to fill out a Volunteer form as well.)

Email *

A consumer report (background screening report) and/or an investigative consumer report which may include information concerning your character, employment history, general reputation, personal characteristics, police record, education, qualifications, motor vehicle record, mode of living, and/or credit and indebtedness may be obtained in connection with your application for and/or continued employment with Community School Corporation of Eastern Hancock County. A consumer report and/or an investigative consumer report may be obtained at any time during the application process or during your employment with the Community School Corporation of Eastern Hancock County. You have the right, upon written request made within a reasonable time after receipt of this notice, to request disclosure of the nature and scope of any investigative consumer report. Please be advised that the nature and scope of the most common form of investigative consumer report obtained with regard to applicants for employment is an investigation into your education and/or employment history conducted by Safe Hiring Solutions LLC, P.O. Box 295, Danville, IN 46122 888-215-8296.

LEGAL Name (first, middle & last): *

Social Security Number: *

Include dashes

Date of Birth (MM-DD-YYYY): *

YYYY

Drivers License Number (ONLY if this background check is for a position that involves transporting students):

Drivers License State (ONLY if this background check is for a position that involves transporting students):

Any other first or last names you have been known by (Ex. maiden name):

Current street address: *

City: *

State: *

Zip: *

List all previous addresses for the last 7 years if different from above:

Telephone number, including area code, to reach you if we have questions: *

Numbers only

What position is this background check for? (i.e. Drama, Bowling, Basketball, Youth League-Football, Cheer, etc.) *

By typing my name below, I hereby voluntarily authorize Community School Corporation of Eastern Hancock County to obtain either a consumer or an investigative consumer report about me from a consumer reporting agency and to consider this information when making decisions regarding my employment and/or continued employment at Community School Corporation of Eastern Hancock County. I understand that I have rights under the Fair Credit Reporting Act, including rights discussed above. This report may be delivered in either written or electronic form.

Type full name to authorize: *

This form will now be submitted directly to the Eastern Hancock Administration Office for processing.

Send me a copy of my responses.

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