Student Employee Pre-employment Form

Student’s Name____________________________________ Eastern ID_____________________

Department________________________________________ Supervisor_________________________________ Job Title_______________________________________ Level III Screening for Student Workers To ensure a safe educational community for the CSCU System, the Connecticut Board of Regents for Higher Education is requiring you to complete a background investigation for the position you are applying for. This will include a Social Security Trace or SSN Validation, County/Statewide Criminal Search, Federal Criminal Search, and Multi-Jurisdictional Criminal Search, in addition to, a Motor Vehicle Record and Credit Verification check for designated positions. Before awarding the position, Eastern will have a Level III pre-employment background investigation performed for the following student worker positions:

1) RA’s 2) Student employees in the Public Safety Department. 3) Student employees handling DCL3 data. 4) Student employees who have a fiduciary responsibility, handle cash or credit transactions, or have a primary

responsibility related to finance or budget. 5) Other positions deemed by the Chief human resource officer to be safety or security sensitive positions.

Job Responsibilities Checklist (To be completed by Supervisor)

Please check any boxes that apply to the responsibilities that this student will have at any point during their employment. These responsibilities will require this student to undergo a pre-employment background investigation.

RA

Public Safety Department

Access to Social Security number

Access to Bank account or debit card information

Access to Credit card number & cardholder information

Access to Student Loan Data

Fiduciary responsibility (Credit Verification)

Handling of cash or credit transactions (Credit Verification)

Primary responsibility related to finance or budget (Credit Verification)

Driving as part of the job (Motor Vehicle Record Check)

Working with Minors

I agree to the terms of employment as described in the job description. I understand that I CANNOT BEGIN WORK until ALL paperwork is complete and returned to the Student Employment Office. Student Signature ______________________________ ________ Date____________________________

Eastern Connecticut State University Office of Financial Aid

(860) 465-4435 / stuemp@easternct.edu

Z:\Policies\Pre-employment form packet Final.pdf

Z:\Policies\Pre-employment form packet Final.pdf

Z:\Policies\Pre-employment form packet Final.pdf

Z:\Policies\Pre-employment form packet Final.pdf