CLIENT'S AUTHORIZATION

Candidate's Last Name Social Security Number

CLIENT'S CASE REQUIREMENTS AND INSTRUCTIONS

Instructions The investigators may verify your claims of educational, training and military attainment.
In addition to checking dates of attendance, questions will be asked concerning your behavior.

You may have listed this information above if the activity was during the scope of the investigation. List it again. Begin with your last period of educational, training or military activity. Include ALL educational and training institutes attended as required by your proctor. Provide concise names and locations of those institutions.

In addition, regardless of when you attended or served, list all college educational and military sevice. Provide details about that institution and/or military organization.

ACHIEVEMENT A.   Background information about blank College Technical High School Trade Military Other

Name of Institution/Service Your ID Number
Institution Street Address
City County State Zip
Area Code   Phone Number Fax Area Code   Fax Number
Did you complete? blank Yes No If no, highest grade or level completed

Reason for leaving blank Graduated Discharged Lost Interest Financial Poor Grades Expulsion Other

Dates of Enrollment/Service:

Enter the Start date : -- mm/dd/yyyy

Enter the Stop date : -- mm/dd/yyyy

Special Accomplishments

What type documentation do you have? blank Diploma Certification Degree DD214 GED Other

ACHIEVEMENT B. ; Background information about blank College Technical High School Trade Military Other

Name of Institution/Service Your ID Number
Institution Street Address
City County State Zip
Area Code Phone Number Fax Area Code Fax Number
Did you complete? blank Yes No If no, highest grade or level completed

Reason for leaving blank Graduated Discharged Lost Interest Financial Poor Grades Expulsion Other

Dates of Enrollment/Service:

Enter the Start date : -- mm/dd/yyyy

Enter the Stop date : -- mm/dd/yyyy

Special Accomplishments


What type documentation do you have? blank Diploma Certification Degree DD214 GED Other

ADVANCED PERSONNEL SECURITY QUESTIONNAIRE(S)

1. To process Employment Verifications, Military Service, Education, or Special References,  it is necessary to utilize additional advanced PSQ (s); ( Personnel Security Questionnaire ).
   
2. If your entries are complete, you may submit the data by clicking on the Submit Button above.
   
3. Select  advanced PSQ that you require from the buttons below.

Additional Advanced Forms

Basic Personnel Security Questionnaire

Criminal and Driving History

Educational, Training and Military Attainment

Employment Activity Detailed