Welcome!

You have been invited by our company to provide information to Cornerstone Information Assurance, LTD for the purpose of initiating a background check.

You are being asked to provide consent for potential employment, whether direct, under contract or as a volunteer, to initiate a background check. Completing the information does not always mean that a background check will be performed.
Before completing the information, you will be advised of your rights under the federal and state laws, which govern background screening for employment purposes, whether direct, under contract or as a volunteer.
Information reported on your background check cannot be used to adversely affect your employment, whether direct, under contract or as a volunteer, without providing you the opportunity to contest the accuracy of the report.
The information you provide is confidential and will only be delivered to the clearly specified recipient(s) listed on the background check consent form.
Before you begin, below are the sections that you will be asked to complete and the type of information that will be required. Allow enough time to complete this process. Please try to complete all sections at one time as you may not necessarily have the option to save partially completed pages.

• Contact Information (Name, phone, and e-mail)
• Address History (Your current address and address history)
• Personal Information (Date of Birth, etc.)

You may also be asked for associated documents related to the information that you provide.

Full Name *:

Email:

Phone number:

I consent to this background check:

I consent to having the results of this background check sent to:

I have read and agree to the terms of use:

I agree to use my full name and email address as a signature.