Employment Screening Services Online Ordering Form - KELMAR Safety, Inc.
KELMAR Safety, Inc. is the Employee Safety Training, Department of Transportation (DOT) Compliance Specialist and Pre-Employment Screening department your company needs to reduce its liability and improve its overall performance McAfee Secure sites help keep you safe from identity theft, credit card fraud, spyware, spam, viruses and online scams
KELMAR Safety Inc.  
 
 

Employment Background Online Ordering Form

Thank you for choosing KELMAR Safety Inc. for your background services. Please fill out the following form completly and click submit when you are done. If you have multiple people you would like for us to perform the same services on then list all of the names on this form. If you have other services that you would like for us to perform, fill out a separate form with the selected services that you have chosen.

NOTE: If you are ordering a Standard DOT Driver Package or having an Employment History Check performed, we must have a copy of the application as well as Signed Release. For your convenience, we have provided you an upload button under the applicant section where you can attach the documents to this form. You may also fax the information to 317.468.1083.

If you do not have a copy of a signed release Download One Here.

Enter Your Contact Information:
First Name: Last Name: Company Name:
Company Location: Daytime Phone: Your Email Address:

Choose your Package:
Package Includes: Criminal, Employment, Motor Vehicle Report
Package Includes: Criminal, DOT Employment, Motor Vehicle Report
Package Includes: Criminal, Employment, Motor Vehicle Report, Credit
Package Includes: Criminal, Employment, Motor Vehicle Report, Education, Credit
Package Includes: Criminal, Employment, Motor Vehicle Report, Credit
Package Includes: Criminal, Employment, Motor Vehicle Report, Education, Credit
Package Includes: Criminal, Employment, Motor Vehicle Report, Education, Credit
Package Includes: Search up to 3 counties as well as a SSN search

Add Additional Reports:
General Employment:
Employment History: (Attach Application Below)
Criminal Check Levels:
 

Type Applicant Information:
First Name: Last Name: Middle Name:
AKA, Alias, Maiden: SSN: DOB:
Position Hiring For: Previous Criminal? If So, Where?
Drivers License Number: Drivers License State:
Type In Any Comments You May Have:
Upload Application: Upload Signed Release: