Category CCriminal Background Check

CBC Category C

Complete the information below, then press the SUBMIT Email button. All fields are required!

Employee Information

Last Name: Birth Date (YYYYMMDD):  
First Name: Employee Contact
Phone Number:     
Aliases (list any former names used): Position Title:

UTSA Affiliation (check all that apply)


Employee Requirements (check all that apply)



  Verify applicant information with a STATE or FEDERAL Picture ID
  Verification Document: If Other, please specify:
  Verification Number:     

Department Information

VP Office:
Dept ID:  
Supervisor Phone:

Preparer's Information

  This information was verified by:
  Full Name:
  Phone Number:
  Email Address:  
  Press the Submit Email button below when completed.