Pre-Employment Checklist

PRE-EMPLOYMENT CHECKLIST

Employer:    Address:

Candidate Information

Position Applied:    Department:    Application Date:

Recitals

WHEREAS, Employer requires verification of candidate qualifications and completion of pre-employment conditions as a condition of hire; and

WHEREAS, Applicant consents to the recordation of this checklist and authorizes verification of information necessary to determine suitability for employment.

Pre-Employment Requirements (to be completed before start date)

Completed employment application    Date:

Resume / CV on file    Date:

Professional references contacted and documented    Date:    Initials:

Background check authorization signed by applicant    Date:

Background check completed    Date:    Result:

Drug screening completed (if applicable)    Date:    Result:

Form I-9 or equivalent identity and employment eligibility documentation completed    Date:

Proof of eligibility provided    Type:    Date:

Education verified    Institution / Degree:    Date:

Professional license / certification verified (if required)    Details:    Date:

Motor vehicle record (MVR) checked (if applicable)    Date:

Vaccination / TB records received (if applicable)    Date:

Offer letter signed and returned    Date:    Start Date:

Conditions & Notices

Conditional Employment: Employment is conditioned upon satisfactory completion of the foregoing items and any lawful background or medical screening required for the position. Adverse findings may result in revocation of the offer or termination of employment. Applicant will be notified in writing of any adverse action resulting from background checks, and afforded any rights required by law to respond.

Certification by Applicant: By signing below, applicant certifies that all information provided is true, complete and correct to the best of applicant's knowledge. Applicant authorizes Employer to investigate and verify any information provided and to obtain consumer and investigative reports where permitted by law.

Confidentiality and Record Retention

All documentation generated in connection with this checklist will be maintained in the Employer's personnel files. Information obtained through verification processes is confidential and will be used solely for employment purposes in accordance with applicable law and Employer policy.

Notes / Findings

Hiring Manager Verification

The Hiring Manager attests that all applicable items above have been completed and that any identified discrepancies are documented in the Notes / Findings section.

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