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Subcontractor & Self-Employed Background Check Request

All fields are required.

Candidate's Name (first and last):

Candidate's Email:

Candidate's Phone:
                                (Include Area Code - 203-333-5555)

Candidate's Company Name:

Requesting Department (Full Title):

Home Organization Number:

Primary Departmental Contact:

Primary Contact Email:

Approving Business Manager:

Will this individual be required to drive a vehicle?

Will this individual have responsibility for financial transactions or the handling of cash valued at or in excess of $50,000 at any point in time?

Will this individual work in any of the following areas: Museums, Galleries, Libraries, Special Collections (storage facility, included), President’s House or Office, Provost’s House or Office, Yale College Dean’s House or at any location(s) which stores, displays, contains, or houses special collections either owned by that location or on loan from Museums, Galleries or Libraries?

Additional Comments: