Electronic Application for Pre-Employment Screening Services
Please tell us about your company:
Company Name:
Physical Address:
Billing Address:
Company Owner/Manager:
Company Owner/Manager Tel:
Company Fax Number:
Owner/Manager Email:
Federal Tax ID/EIN Number:
Your monthly invoices will be sent to the following two accounts payable contacts:
Facility Accounts Payable Contact:
Facility Accounts PayableTel:
Accounts Payable Email:
Corporate Account Payable Contact:
Corporate Account PayableTel:
Corporate Account Payable Email:
Your background searches will be sent to the following Human Resources contact as a default.
Default Human Resources Contact:
Human Resources Tel:
Human Resources Email:
Alt #2 HR Contact:
Alt #2 HR Email:
Please tell us which services you are interested in doing.
Please tell us about your industry.
Staffing & Referral Healthcare and Related Industries
Convenience Store & Oil Companies Lodging, Apts, Hotels, Real Estate
Restaurants and Food Services
Churches, Schools, and Colleges
Not for Profit and Philanthropies
Administrative, Legal, and Banking
Other
Please let us know how you found out about our company.
By inserting my signature and date below I certify that I have read and understand all terms and conditions of the Information On Demand, Inc. Background (linked to directly below this certification block) . I further certify that I am an representative of this company
Link to Information On Demand, Inc. Background Report Agreement
Authorized Signature Required: Date Signed:
