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TEMPORARY EMPLOYEE APPOINTMENT CHECKLIST
REQUIRED DOCUMENTS
NAME_________________________________ DEPARTMENT___________________________ ______REQUISITION
http://hr.wayne.edu/clientservices/recruiting/requisition-temporary-employee_direct_hire.pdf
______ HR-POS Completed via EPAF
______ APPLICATION FOR EMPLOYMENT http://hr.wayne.edu/clientservices/recruiting/temporary-employment-application.pdf
______ EMPLOYEE DATA SHEET http://hr.wayne.edu/clientservices/current/employee-data-sheet.pdf
______ CONDITIONS OF EMPLOYMENT http://hr.wayne.edu/clientservices/recruiting/conditions-of-employment-for-temporary-employees.pdf
______ *Employees must complete Section I of the employment eligibility verification via I-9 Express (http://www.newi9.com/) prior to the date of hire. *U.S. citizens, permanent residents and non-resident aliens must finalize the I-9 verification process by appearing in person with the appropriate ORIGINAL documents at the School of Medicine Human Resources/MPN Office located in room 154 Lande on or before the date of hire between 8:30 and 5:00. (PROVIDE the email approval copy of the Work Authorization Request Form where applicable).
The I-9 requirement is not necessary if the employee has completed the I-9 process at Wayne State University within the last three years.
______ U.S. VETERAN SURVEY http://oeo.wayne.edu/resources/forms.php
______ NEPOTISM STATEMENT (if applicable)
______ EXCEPTION TO HOURLY RATE MEMO (IF APPLICABLE)
______ TAX FORMS:
______ Federal (W-4)
______ State (MI-W4)
______ City (DW-4)
______ BACKGROUND CHECK SUBMITTED TO [email protected] on ___/___/_____ (request is attached)
COMMENTS:_____________________________________________________________________________
_______________________________________________________________________________________
_______________________________________________________________________________________
QUESTIONS ABOUT THIS APPOINTMENT PACKET SHOULD BE DIRECTED TO: NAME________________________________________ TELEPHONE:______________________ (REVISED 4/15/2015)
School of Medicine ◊ UME Business Office ◊ 2305 Scott Hall 540 E. Canfield ◊ Detroit, MI 48201 ◊ Voice: 313-‐577-‐1415 ◊ Fax: 313-‐577-‐0033
EMPLOYMENT PROCEDURES FOR TEMPORARY EMPLOYEES Ø Complete and submit each of the following forms:
1. Employee Data Form (Be sure to put emergency contact information) 2. Application for Employment Form 3. Conditions for Employment 4. Veteran Survey Form 5. Tax Forms
a. Federal (W-‐4) b. State (MI-‐W4) c. City (DW-‐4)
Ø Fill out the online 1-‐9 form go to http://www.newi9.com/
1. Print off a completed copy of 1-‐9 form 2. The Human Resources Identification Requirements-‐ See List Attached 3. Identification Requirements you can choose one from List A or one from both
lists B and C for identification, which is required 4. Must take copy of 1-‐9 and required identification documents to Human
Resources at Lande Building, Room 154 between the hours of 8:30AM-‐ 5:00 PM, Monday through Friday-‐ 577-‐6824-‐ you must go to Human Resources/MPN for verification purposes
5. The 1-‐9 requirement is not necessary if this process has been completed at Wayne State University within the last three years
BACKGROUND CHECK INFORMATION-‐ CONTINGENCY STATEMENT Congratulations on your recent job offer! This offer is contingent upon a satisfactory background check that is required by University policy for this position, including, but not limited to, a criminal background check. If the University determines that your background check results are unsatisfactory, this offer shall be revoked or, if your employment has already commenced, your employment will be immediately terminated. As part of this process, you will receive an e-‐mail invitation with instructions from "A-‐CHECK AMERICA" to complete the screening application (reference guide has been included) or complete a paper Authorization for Background Check form.
Revised 9/25/2009
Requisition for Temporary Employee
Candidate Information
Date Prepared:
Candidate Name:
Banner/SS#:
Position#:
Assignment Start Date:
Assignment End Date:
Immediate Supervisor: School/College/Division:
Department and Code: Recommended Hourly Rate:
Approximate hours of work per week
Is the candidate related to anyone presently working for Wayne State University? Yes No If yes, indicate the following: Name: Position: Department:
Reason for Appointment
Short Term
Projects
Sick Leave Replacement
Vacation
Leave Replacement
Peak Period
Workload
Filling vacant position currently posted until
full-time employee can start work
Replacing (Last Name, First Name): If Applicable
Classification of Person Replaced: E-class Department:
Occupational Title Associated with Duties (i.e., Secretary, Research Assistant) Do not use Technician or Temporary as title:
Description of Duties
Supervisor Signature: Date:
School/College/Division Approval
Department Head Signature: Date:
School/College/Division Head Signature: Date:
NOTE: Candidate should not begin work until all personnel paperwork has been completed
Division of Human Resources Employment Service Center
Employee Data Sheet
Employment Resource Center5700 Cass Ave, Suite 3638
Detroit, MI 48202Phone: 313-577-3000
Fax: 313-577-0637www.hr.wayne.edu
Date:
New Revised
Employee's Legal Name: (Last, First, Middle) (As displayed on SSN/ITIN Card)
Home Address:
Home Phone:
Campus Address:
SSN:
Campus Phone:
Banner ID:
City/State/Zip:
Date of Birth:Male
Female
What is your race? (Select one or more):
Marital Status Citizenship
Married
Single
Citizen
Non-Citizen
Permanent Resident
In which languages are you fluent?
Are you Hispanic or Latino?
Yes
No
This information is voluntary and will be used for statistical purposes only.
AS, Asian
BL, Black or African-American
PH, Native Hawaiian and Other Pacific Islander
WH, White
AM, Native American/Native Alaskan
Will 100% of the work be performed in Detroit, MI? Yes No
If NO, what City, State/Province and Country will the work be performed in? State/Province Country
EndorsedExpiration Date
Year of Graduation
DegreeCity/State/Country
Education History
DateCertification
Professional Certifications and Licenses
Employee Signature
Institution
Date
Name:
Phone:
City/State/Zip:
Address:
Person to Notify in Case of Emergency
Revision (5/2015)
Posting Number:
Position Title:
Application Date and Time:
Personal Information Last Name:
First Name:
Middle Name:
Other names you have been known by or have used:
Social Security Number:
Address:
City:
State/Province:
Zip Code/Postal Code:
Home Phone:
Work Phone:
Cell/Other Phone:
International Phone:
E-mail:
Emergency Contact Name:
Emergency Contact Phone:
How much notice do you have to provide before starting?
Salary Desired:
What type of employment are you seeking?
Are you 18 years or older?
Are you legally authorized to work in the United States?
Are you currently employed by Wayne State University?
If yes, please provide your Banner ID:
If you are a member of a Wayne State bargaining unit, please select the bargaining unit:
Have you ever been employed by Wayne State University?
If yes, indicate location, position, and dates of employment:
Are you related to anyone presently working for Wayne State University?
If Yes, specify name, relationship and department:
Are you currently a student at Wayne State University?
If yes, indicate current term enrolled, give year and number of hours enrolled:
Have you ever been a student at Wayne State University?
How were you referred?
Friend Relative Walk-In
Job Fair Advertisement Employment Agency
WSU Employee Website Other
High School Name of High School:
City:
State/Province/Country:
Did you graduate?
Higher Education
Name of School:
Major:
Number of years completed:
Did you graduate?
Degree:
Work Experience
Employer Name:
Job Title:
Dates Employed:
From:
To:
Starting Salary:
Ending Salary:
Supervisor's Name:
Supervisor's Title:
Supervisor's Phone:
Reason for Leaving:
Work Performed:
May we contact this employer?
Type of Employment:
Employer Name:
Job Title:
Dates Employed:
From:
To:
Starting Salary:
Ending Salary:
Supervisor's Name:
Supervisor's Title:
Supervisor's Phone:
Reason for Leaving:
Work Performed:
May we contact this employer?
Type of Employment:
Employer Name:
Job Title:
Dates Employed:
From:
To:
Starting Salary:
Ending Salary:
Supervisor's Name:
Supervisor's Title:
Supervisor's Phone:
Reason for Leaving:
Work Performed:
May we contact this employer?
Type of Employment:
References
Name:
Occupation:
How do you know this reference?:
Address:
Phone number:
Email:
May we contact this reference?
Name:
Occupation:
How do you know this reference?:
Address:
Phone number:
Email:
May we contact this reference?
Name:
Occupation:
How do you know this reference?:
Address:
Phone number:
Email:
May we contact this reference?
Miscellaneous
Please provide any Licenses. (Please include license number, expiration date and sponsor/provider e.g. License XYZ, 02-02-2004, Provider):
Please provide any Certifications. (Please include certification number, expiration date and sponsor/provider e.g. Certification XYZ, 02-02-2004, Provider).
Please list any special skills or qualifications:
Agreement I certify that my statements are true and accurate. I understand that my employment is contingent upon satisfactory verification of the information indicated on this application and other information submitted in support of my application for employment. If employed, I understand that any misrepresentation found after I am on the job will be considered sufficient grounds for dismissal. I hereby authorize Wayne State University to investigate my past employment and/or activities and statements contained in this application and release from all liability and responsibility all persons, companies, or corporations supplying such information. I understand that such information may include reports or records of disciplinary action assessed by previous employers, and specifically waive written notice of such disclosure and release such parties from any obligation to provide me with such notification, in accordance with Michigan Complied Laws 423.506. Applicants or employees who need any accommodation for a disability should request one by contacting the Employment Services Center at 313-577-2010. In consideration of my employment, I agree to conform to all Wayne State University policies and procedures, including applicable collective bargaining agreements and employee handbooks. Except to the extent that such then current policies and procedures explicitly provide otherwise, I agree that my employment and compensation may be terminated, with or without cause and with or without notice at any time, at the option of either Wayne State University or myself, I understand that no manager, faculty member, or other representative of Wayne State University, other than the President, has any authority to enter into any agreement, oral or otherwise, contrary to the foregoing, and that no such agreement shall be given effect unless it has been reduced to writing and signed by both the president and me.
BY SIGNING BELOW, I certify that I have read and agree with these statements.
Applicant's Name Applicant's Signature Date
Wayne State University is an affirmative action/equal opportunity employer.
MEMORANDUM
TO: All Faculty and Staff
FROM: Office of Equal Opportunity
RE: Confidential Survey to Identify Faculty and Staff with Disabilities and U.S. Veterans
Wayne State University is committed to equal opportunity, non discrimination and affirmative action. Federal regulations require Wayne State to maintain data on persons with disabilities and U.S. Veterans. The questionnaire printed on the next page(s) will allow you to self-identify as a person with a disability and/or a U.S. Veteran. This data will be used to evaluate Wayne State’s efforts in assuring access, promotional and equal opportunities to the disabled and veterans. We will routinely request this information from new employees to update this data.
The data you provide is considered CONFIDENTIAL. However, for affirmative action or safety purposes, data may be submitted to the following:
1. Applicable supervisors or managers to facilitate the provision of reasonable accommodations in the design or renovation/alteration of buildings, facilities, fixtures, furniture or job structures;
2. Government officials during review of Wayne State University legal compliance; 3. Human Resources ADA Coordinator for notification of opportunities or activities for
employees with disabilities or veterans; 4. First aid or safety personnel.
Your participation in this survey is VOLUNTARY and helps the University’s equal opportunity, non-discrimination and affirmative action efforts.
Please complete the survey, seal and return the form to the Office of Equal Opportunity. If you should have any questions, please contact the Office of Equal Opportunity at (313) 577-2280.
Thank you for your cooperation.
Wayne State University is an affirmative action/equal opportunity employer.
WAYNE STATE UNIVERSITY OFFICE OF EQUAL OPPORTUNITY
DISABLED PERSONS & U.S. VETERANS VOLUNTARY SURVEY
THIS INFORMATION IS VOLUNTARY AND CONFIDENTIAL
PRINT NAME:___________________________________ BANNER ID # _________________
Please check one: Faculty □ Staff □
FOR EMPLOYEES WITH DISABILITIES
Disability Definitions: A determinable physical or mental characteristic of an individual, which may result from disease, injury, congenital condition of birth, or functional disorder, if the characteristic substantially limits one or more major life activities of that individual, and is unrelated to the individual’s ability to perform the duties of a particular job or position or substantially limits one or more of the major life activities of that individual, and is unrelated to the individual’s qualifications for employment or promotion (Persons With Disabilities Civil Rights Act). Or, a person who has a physical or mental impairment that substantially limits one or more major life activities; has a record of such impairment or is regarded as having such impairment (Americans with Disabilities Act).
Please Check one: Do you believe you have a disability? YES □ NO □
Do you use disability accommodations provided
by the University? YES □ NO □
If “yes”, please check all of the following types of accommodations you use: ____ Access (e.g. ramps, disability parking, special
classroom location, etc.) ____ Job restructuring ____ Special equipment (e.g., amplifying device, special
computer, etc.) ____ Other ___________________________
Would you like to receive a packet of information on requesting an accommodation, including the necessary request forms?
YES □ NO □ If yes, please provide your mailing address the appropriate information may be sent to you. ___________________________ _____________________ ______ ____________
Address City State Zip Code
Wayne State University is an affirmative action/equal opportunity employer.
FOR U.S. VETERANS
The following are definitions of various categories of U.S. Veterans. Please read them carefully and determine which category or categories describes you and check ALL of the categories which describe you.
� ‘Disabled Veteran’ means (i) a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs, or (ii) a person who was discharged or released from active duty because of a service-connected disability.
� Special Disabled Veteran’ means a veteran who is entitled to compensation under laws administered by the Department of Veterans Affairs for a disability rated at 30 percent or more; or, rated at 10 or 20 percent, if it has been determined that the individual has a serious employment disability; or, a person who was discharged or released from active duty because of a service-connected disability.
� ‘Other Protected Veteran’ means a veteran who served on active duty during a war or in a campaign or expedition for which a campaign badge has been authorized.
� ‘Newly Separated Veteran’ means any veteran who served on active duty in the U.S. military, ground, naval or air service during the one-year period beginning on the date of such veteran’s discharge or release from active duty. (If you were discharged from active duty within a 12-month period prior to beginning employment.)
� ‘Recently Separated Veteran’ means a veteran during the three-year period beginning on the date of such veteran’s discharge or release from active duty in the U.S. Military, ground, naval or air service. (If you were discharged from active duty within a 3-year period prior to beginning employment.)
� ‘Veteran of the Vietnam Era’ means a veteran who (1) served on active duty for a period of more than 180 days, any part of which occurred between August 5, 1964 and May 7, 1975, and was discharged or released with other than a dishonorable discharge; (2) was discharged or released from active duty for a service connected disability if any part of such active duty was performed between August 5, 1964 and May 7, 1975; or (3) served on active duty for more than 180 days and served in the Republic of Vietnam between February 28, 1961 and May 7, 1975.
� ‘Armed Forces Service Medal Veteran’ means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Force service medal was awarded pursuant to Executive Order 12985 (see http://www.opm.gov/veterans/html/vgmedal2.asp)
___________________________ _____________________ Signature Date Print Name
5. Are you a new employee?
9. Employee's Signature
Home Address (No., Street, P.O. Box or Rural Route)
3. Type or Print Your First Name, Middle Initial and Last Name
EMPLOYEE'S MICHIGAN WITHHOLDING EXEMPTION CERTIFICATESTATE OF MICHIGAN - DEPARTMENT OF TREASURY
MI-W4(Rev. 8-08)
This certificate is for Michigan income tax withholding purposes only. You must file a revised form within 10 days if your exemptions decrease or your residency status changes from nonresident to resident. Read instructions below before completing this form.
Issued under P.A. 281 of 1967.
Under penalty of perjury, I certify that the number of withholding exemptions claimed on this certificate does not exceed the number to which I am entitled. If claiming exemption from withholding, I certify that I anticipate that I will not incur a Michigan income tax liability for this year.
Date
11. Federal Employer Identification Number
Enter the number of personal and dependent exemptions you are claimingAdditional amount you want deducted from each pay(if employer agrees)
6.7.
8.
a.b.c.
EMPLOYEE:If you fail or refuse to file this form, youremployer must withhold Michigan income taxfrom your wages without allowance for anyexemptions. Keep a copy of this form for yourrecords.
INSTRUCTIONS TO EMPLOYER:Employers must report all new hires to the Stateof Michigan. Keep a copy of this certificate withyour records. If the employee claims 10 or morepersonal and dependent exemptions or claims astatus exempting the employee fromwithholding, you must file their original MI-W4form with the Michigan Department of Treasury.Mail to: New Hire Operations Center, P.O. Box85010; Lansing, MI 48908-5010.
$ .00
Employer: Complete lines 10 and 11 before sending to the Michigan Department of Treasury.10. Employer's Name, Address, Phone No. and Name of Contact Person
4. Driver License Number
6.
7.
A Michigan income tax liability is not expected this year.Wages are exempt from withholding. Explain: _______________________________________________________Permanent home (domicile) is located in the following Renaissance Zone: _________________________________
Yes
No
If Yes, enter date of hire . . . .
If you hold more than one job, you may not claim the sameexemptions with more than one employer. If you claim thesame exemptions at more than one job, your tax will be underwithheld.
Line 7: You may designate additional withholding if you expect to owe more than the amount withheld.
Line 8: You may claim exemption from Michigan income tax withholding ONLY if you do not anticipate a Michigan incometax liability for the current year because all of the followingexist: a) your employment is less than full time, b) yourpersonal and dependent exemption allowance exceeds yourannual compensation, c) you claimed exemption from federalwithholding, d) you did not incur a Michigan income tax liabilityfor the previous year. You may also claim exemption if yourpermanent home (domicile) is located in a Renaissance Zone.Members of flow-through entities may not claim exemptionfrom nonresident flow-through withholding. For moreinformation on Renaissance Zones call the Michigan Tele-HelpSystem, 1-800-827-4000. Full-time students that do not satisfyall of the above requirements cannot claim exempt status.
Web SiteVisit the Treasury Web site at:www.michigan.gov/businesstax
INSTRUCTIONS TO EMPLOYEEYou must submit a Michigan withholding exemption
certificate (form MI-W4) to your employer on or before the datethat employment begins. If you fail or refuse to submit thiscertificate, your employer must withhold tax from yourcompensation without allowance for any exemptions. Youremployer is required to notify the Michigan Department ofTreasury if you have claimed 10 or more personal anddependent exemptions or claimed a status which exempts youfrom withholding.
You MUST file a new MI-W4 within 10 days if your residencystatus changes or if your exemptions decrease because: a)your spouse, for whom you have been claiming an exemption,is divorced or legally separated from you or claims his/her ownexemption(s) on a separate certificate, or b) a dependent mustbe dropped for federal purposes.
Line 5: If you check "Yes," enter your date of hire (mo/day/year).
Line 6: Personal and dependent exemptions. The total number of exemptions you claim on the MI-W4 may not exceed thenumber of exemptions you are entitled to claim when you fileyour Michigan individual income tax return.
If you are married and you and your spouse are both employed, you both may not claim the same exemptions witheach of your employers.
1. Social Security Number 2. Date of Birth
City or Town State ZIP Code
I claim exemption from withholding because (does not apply to nonresident members of flow-through entities - see instructions):
EMPL
OYEE
’S W
ITHHO
LDIN
G CE
RTIFI
CATE
FOR
CITY
OF D
ETRO
IT IN
COME
TAX
DW
-4
1. P
rint F
ull N
am e
S oci
al S
ecur
ity N
o.
Of fi
ce, P
lant
, Dep
t. Em
ploy
ee Id
entif
icat
ion
No.
2. A
ddre
ss, N
umbe
r and
Stre
et
City
, To w
nshi
p or
V illa
ge w
here
you
resi
de
Stat
e Zi
p C
ode
3. P
redo
min
ant P
lace
of E
mpl
oym
ent
Prin
t nam
e of
eac
h ci
ty w
here
you
wor
k fo
r thi
s em
ploy
er a
nd c
ircle
clo
sest
% o
f tot
al e
arni
ngs
in e
ach.
City
U
nder
Re
naiss
ance
Zon
e Ex
empt
io n
25%
40
%
60%
80
%
100%
City
U
nder
Re
naiss
ance
Zon
e Ex
empt
io n
25%
40
%
60%
80
%
100%
YOUR
WIT
HHO
LDIN
G
EXEM
PTIO
NS:
Chec
k bl
ocks
wh
ich
appl
y (S
ee in
stru
ctio
ns o
n re
vers
e sid
e. )
4. E
xem
ptio
ns
Regu
lar
Addi
tiona
l exe
mpt
ion
if Ad
ditio
nal
for y
ours
elf
exem
ptio
n 65
or o
ver a
t end
of y
ear
exem
ptio
n if
blin
d En
ter n
umbe
r o f
exem
ptio
ns c
heck
ed
5. E
xem
ptio
ns fo
r Re
gula
r Ad
ditio
nal e
xem
ptio
n if
Addi
tiona
l yo
ur w
ife (h
usba
nd)
exem
ptio
n 65
or o
ver a
t end
of y
ear
exem
ptio
n if
blin
d En
ter n
umbe
r o f
exem
ptio
ns c
heck
ed
6. (
a) E
xem
ptio
ns fo
r you
r chi
ldre
n Nu
mbe
r Ex
empt
ions
for y
our o
ther
de
pend
ent s
6.
(b )
Nu
mbe
r En
ter t
otal
o f
line
6 (a
plu
s b)
7. A
dd th
e nu
mbe
r of e
xem
ptio
ns w
hich
you
hav
e cla
imed
on
lines
4, 5
and
6 a
bove
and
writ
e th
e to
ta l
I cer
tify
that
the
info
rmat
ion
subm
itted
on
this
certi
ficat
e is
true,
cor
rect
and
com
plet
e to
the
best
o f
my
know
ledg
e an
d be
lie f
8. D
at e
S ign
atur
e
EMPL
OYE
E: F
ile t
h is
form
w ith
y ou
r em
ploy
er . O
ther
wis
e he
mus
t w ith
hol d
CI
TY O
F DE
TRO
I T in
com
e ta
x fro
m y
our
earn
ings
with
out e
xem
ptio
n.
EMPL
OYE
R: K
eep
this
cer
tific
ate
w ith
yo
ur re
cord
s. If
the
info
rmat
ion
subm
itted
by
the
empl
oyee
is n
ot b
elie
ved
to b
e tru
e,
corre
ct a
nd c
ompl
ete,
the
INC
OM
E TA
X D
IRE
CT O
R m
ust
be
so
adv
ised
.
F 4 5 0 1 - 2 4 1 3 - O
LIN
E 3
INST
RU
CTI
ON
S —
If y
ou w
ork
for t
his
empl
oyer
in m
ore
than
two
citie
s or
com
mun
ities
, prin
t nam
es o
f the
two
Mic
higa
n ci
ties
or c
omm
uniti
es w
here
you
per
form
the
grea
test
per
cent
age
of y
our w
ork.
Circ
le th
e cl
oses
t per
cent
of
tota
l ear
ning
s fo
r wor
k do
ne o
r ser
vice
s re
nder
ed in
eac
h ci
ty o
r com
mun
ity li
sted
. The
est
imat
ed p
erce
nt o
f tot
al e
arni
ngs
from
this
em
ploy
er fo
r wor
k do
ne o
r ser
vice
s pe
rform
ed w
ithin
taxi
ng c
ities
(lin
e 3
on o
ther
sid
e) is
for w
ithho
ldin
g pu
rpos
eson
ly. In
det
erm
inin
g fin
al ta
x lia
bilit
y th
is e
stim
ate
is s
ubje
ct to
sub
stan
tiatio
n an
d au
dit.
REN
AISS
ANC
E ZO
NE
EXEM
PTIO
N —
Atta
ch c
opy
of C
ertif
icat
ion
of Q
ualif
icat
ion.
EXEM
PTIO
NS
— A
n em
ploy
ee is
allo
wed
the
sam
e nu
mbe
r of e
xem
ptio
ns fo
r him
self
and
depe
nden
ts a
s fo
r fed
eral
inco
me
tax
purp
oses
, exc
ept t
hat a
dditi
onal
with
hold
ing
allo
wan
ces
clai
med
on
Sche
dule
A o
f Fed
eral
For
m W
-4 a
re n
otal
low
ed fo
r City
of D
etro
it in
com
e ta
x pu
rpos
es.
CH
ANG
ES IN
EXE
MPT
ION
S —
You
sho
uld
file
a ne
w c
ertif
icat
e w
ith y
our e
mpl
oyer
at a
ny ti
me
the
num
ber o
f you
rex
empt
ions
cha
nges
.
CH
ANG
E O
F R
ESID
ENC
E —
You
mus
t file
a n
ew c
ertif
icat
e w
ithin
10
days
afte
r you
cha
nge
your
resi
denc
e fro
m o
rto
a ta
city
.
CH
ANG
ES IN
EM
PLO
YMEN
T —
You
mus
t file
a n
ew c
ertif
icat
e by
Dec
embe
r 1 o
f eac
h ye
ar if
you
r Lin
e 3
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Candidate Reference Guide - Background Screening Application Congratulations on your recent job offer at Wayne State University. As previously mentioned, this offer is contingent upon the completion of a satisfactory background check that is required by University policy for this position, including, but not limited to, a criminal background check. If the University determines that your background check results are unsatisfactory, this offer shall be revoked. As part of this process, you will receive an e-mail invitation with instructions from A-Check America to complete the background screening application. IMPORTANT NOTE: You have been given 72 hours to complete the background screening application. Failure to complete this application may result in revocation of your job offer.
Please find below a helpful guide to assist you in completing the background screening application. Once the background process has been completed, you will be contacted by the Hiring Manager or Human Resources (for Non-Academic positions only).
1. You will receive an e-mail invitation from with the Subject “A-CHECK AMERICA – BACKGROUND SCREENING INVITATION”
2. The e-mail will contain a system generated Login information. You will need this information to access the website.
3. Select Accept Invitation to begin the
background screening application. Note: Your job offer is contingent upon successful completion of a background check. By selecting “Decline Invitation” you are disqualifying yourself from consideration.
1. Once you select the Accept Invitation link,
you will be directed to the Applicant Portal at A-Check America.
2. Enter your username and password from the e-mail invitation you received.
3. Click the Login button.
STEP 1: E-MAIL INVITATION FROM A-CHECK
STEP 2: LOGIN
For assistance in completing your background application please contact: A-Check America
Toll free: 877-345-2021 Direct: 951-750-1501
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1. After reading the welcome message, click Start Application.
2. At this point, you will be taken to the application wizard to complete the following sections:
� Personal Information: Be sure to
enter your full legal name as it appears on your Government documents.
� Driver’s Record: Make sure you have a valid Driver’s license number ready.
� Education: You will be asked to provide the highest level of education completed.
� Employment History: You will be asked to provide all employment history within the past 7 years
� Disclosed Offenses: You will be given an opportunity to disclose any criminal records. Please provide as much accurate information as you have available to you.
1. Once you have completed all sections, click Complete Application. IMPORTANT: You MUST click the Complete Application button in order for A-Check to begin the screening process
2. You will receive a confirmation message and file number. For your record, you should retain the file number or print a copy by clicking the Print Confirmation button.
STEP 3: COMPLETING THE BACKGROUND SCREENING APPLICATION
STEP 4: COMPLETING THE BACKGROUND SCREENING APPLICATION – FINAL STEPS