Background Check Request Form

Please complete the following fields to request a criminal background check. Please do not use this form for staff or faculty being hired through normal processes. Please contact pebc@vanderbilt.edu if you have any questions.

Candidate Name Candidate Name First Last
Candidate Email
Projected Start Date Projected Start Date / MM / DD YYYY

Please note that a background check must be completed and cleared before the individual may begin work of any kind, paid or unpaid.
Person Requesting Check (Results will be returned to this person) Person Requesting Check (Results will be returned to this person) First Last
Work Unit Name
Type of Check Requested

Type of Check Requested Protection of Minors Check Current Vanderbilt Student Graduating Vanderbilt Student Unpaid Intern Paid Intern Volunteer Temporary Employee Other Other
Is this individual over the age of 18?

Is this individual over the age of 18? Yes No
Has this individual been employed by Vanderbilt University as staff, faculty, or student worker?

Has this individual been employed by Vanderbilt University as staff, faculty, or student worker? Yes No
If they have been employed by Vanderbilt University, please enter their employee ID number.
Must be 7 digits. Currently Entered: 0 digits.
Will this person receive compensation for work and need to complete Federal Form I-9? If you select yes, the I-9 will be initiated with the background check.

Will this person receive compensation for work and need to complete Federal Form I-9? If you select yes, the I-9 will be initiated with the background check. Yes No
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