HR Call Request Form

HR Call Request Form

Use this form to request a scheduled telephone or video call with Human Resources for recruitment, onboarding, benefits, or employment verification matters. Complete all applicable fields. HR will attempt to contact at the preferred times listed below. Submission of this form constitutes authorization to contact listed references and previous employers for employment verification and background screening as described in the Authorization section.

Personal Information

Phone:    Email:

Phone call    SMS/text    Email    Video call

Preferred Call Times

Best days (select all that apply):    Monday    Tuesday    Wednesday    Thursday    Friday

Preferred time window: From to . Alternate times or notes:

Position Information

Hiring Manager / Requestor:    Desired start date:

Employment History (Most Recent)

Title:    Supervisor:

Dates employed: From to

Employment History (Prior)

Title:    Supervisor:

Dates employed: From to

Education

Graduation / Completion Date:

Professional References

Legal Disclosures & Authorizations

At-Will Employment Statement: Submission of this form does not create an employment contract. Employment, if offered, will be on an at-will basis, meaning that either the employee or the employer may terminate employment at any time, with or without cause or notice, subject to applicable law.

Equal Employment Opportunity: The company provides equal employment opportunity in all hiring and employment practices without regard to protected characteristics as defined by applicable law.

Authorization to Contact and Background Check: I authorize the verification of all information provided on this form and give permission to contact my current and former employers, references, and other listed parties to obtain information relevant to my candidacy or employment status. I also authorize a background investigation, which may include, where permitted by law, criminal history, credit history, education verification, and other job-related checks.

Consent to Release: By checking the consent box below I release all parties from liability for any damage that may result from furnishing such information to the company.

I authorize background checks and the contacting of previous employers and references for the purposes stated above.

Applicant Certification

I certify that the information provided on this form is true, complete, and accurate to the best of my knowledge. I understand that any misrepresentation or omission may result in rejection of this request or, if employed, disciplinary action up to and including termination. I understand that submission of this form is not an offer of employment.

I certify that the statements above are true and that I have read and understand the disclosures in this form.

Additional Information / Notes

HR Use Only

Date Requested:    Priority:

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