Apply In Michigan

Background Authorization

Name(Required)

First Middle Last

Former Name Used and Dates When Used

Current Address(Required)

Street Address Address Line 2 City State ZIP Code

How long have you lived at current address? (# of Years and Months)(Required)

Previous Address (if at current address less than 3 years)

Street Address Address Line 2 City State ZIP Code

Date of Birth(Required)

SSN (numbers only)(Required)

Driver’s License or Identification #(Required)

State that issued License or ID(Required)

Cell Phone #(Required)

Home Phone #

Signature(Required)

I hereby authorize Aggressive Hiring Group and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or investigative consumer report to be generated for employment and/or volunteer purposes. I understand that the scope of the consumer report/investigative consumer report may include, but is not limited to the following areas: verification of social security number, credit reports, current and previous residences, employment history, education background, character references, drug testing, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions, driving records, birth records, and any other public records.

Date