Background and Driving Record Check

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Password must contain the following:

12 Characters
1 Uppercase letter
1 Lowercase letter
1 Number
1 Special character

Background Check Information

The background check requires your legal name. Please enter what is on your Driver's License or Passport

First Name (Legal Name)

Middle Name

Last Name

Other Name Known By?

Please select the position to which you have applied or currently work:

VolunteerVolunteer - UM SLATE Student Mentor GroupInternAmeriCorps VISTAPaid Position (full-time, part-time, work-study)OtherVolunteers do not need to complete a Driving Record Check unless specifically instructed.

If "Other," please describe:

Social Security Number

This is a secure web form.

Receive a call from staff to retrieve SSN over the phone instead (please type "N/A" in the SSN box)

If you are an international student or visiting the U.S. and do not have a SSN, please type "N/A" in the SSN box above and upload a scanned image of your passport here:

Scanned passport image

Date of Birth (mm/dd/yyyy)

Address

Address Line 1

Include Apartment or Unit Number separated by a comma

City

State

Zip Code

Have you been convicted of a crime in the court of law?

YesNoOther

If "Yes" or "Other," Please Explain:

Do you have a Driver's License?

YesNo

Driving Record Check Information

State

Driver's License Number

Driver's License Type

Other:

State ID

Select your State and put "N/A" in the ID Number field if you do not have a State ID.

State

ID Number

The information supplied in this form is accurate to the best of my knowledge.

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