{"id":735,"date":"2014-02-19T21:22:50","date_gmt":"2014-02-19T21:22:50","guid":{"rendered":"http:\/\/www.srcpi.com\/WP\/?page_id=735"},"modified":"2014-02-19T21:23:14","modified_gmt":"2014-02-19T21:23:14","slug":"background-check-request-form","status":"publish","type":"page","link":"https:\/\/www.srcpi.com\/WP\/background-check-request-form\/","title":{"rendered":"Background Check Request Form"},"content":{"rendered":"<div id=\"vfb-form-4\" class=\"visual-form-builder-container\"><form id=\"background-check-request-form-4\" class=\"visual-form-builder vfb-form-4 \" method=\"post\" enctype=\"multipart\/form-data\">\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"4\" \/><fieldset class=\"vfb-fieldset vfb-fieldset-1 background-check-request-form \" id=\"item-vfb-98\"><div class=\"vfb-legend\"><h3>Background Check Request Form<\/h3><\/div><ul class=\"vfb-section vfb-section-1\"><li class=\"vfb-item vfb-item-text  \" id=\"item-vfb-102\"><label for=\"vfb-102\" class=\"vfb-desc\">Company Requesting <\/label><input type=\"text\" name=\"vfb-102\" id=\"vfb-102\" value=\"\" class=\"vfb-text  vfb-medium   \" \/><\/li><li class=\"vfb-item vfb-item-instructions   vfb-left-third\" id=\"item-vfb-103\"><label class=\"vfb-desc\">If New Client <\/label><\/li><li class=\"vfb-item vfb-item-text   vfb-right-two-thirds\" id=\"item-vfb-104\"><label for=\"vfb-104\" class=\"vfb-desc\">Address 1 <\/label><input type=\"text\" name=\"vfb-104\" id=\"vfb-104\" value=\"\" class=\"vfb-text  vfb-medium   \" \/><\/li><li class=\"vfb-item vfb-item-text   vfb-right-two-thirds\" id=\"item-vfb-105\"><label for=\"vfb-105\" class=\"vfb-desc\">Address 2 <\/label><input type=\"text\" name=\"vfb-105\" id=\"vfb-105\" value=\"\" class=\"vfb-text  vfb-medium   \" \/><\/li><li class=\"vfb-item vfb-item-text   vfb-right-two-thirds\" id=\"item-vfb-106\"><label for=\"vfb-106\" class=\"vfb-desc\">Town \/ State \/ Zip Code <\/label><input type=\"text\" name=\"vfb-106\" id=\"vfb-106\" value=\"\" class=\"vfb-text  vfb-medium   \" \/><\/li><li class=\"vfb-item vfb-item-text   vfb-left-half\" id=\"item-vfb-107\"><label for=\"vfb-107\" class=\"vfb-desc\">Company Contact  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-107\" id=\"vfb-107\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-email   vfb-right-half\" id=\"item-vfb-108\"><label for=\"vfb-108\" class=\"vfb-desc\">Email  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"email\" name=\"vfb-108\" id=\"vfb-108\" value=\"\" class=\"vfb-text  vfb-medium  required  email \" \/><\/li><li class=\"vfb-item vfb-item-phone   vfb-left-half\" id=\"item-vfb-109\"><label for=\"vfb-109\" class=\"vfb-desc\">Company Phone <\/label><input type=\"tel\" name=\"vfb-109\" id=\"vfb-109\" value=\"\" class=\"vfb-text  vfb-medium   phone \" \/><\/li><li class=\"vfb-item vfb-item-phone   vfb-right-half\" id=\"item-vfb-110\"><label for=\"vfb-110\" class=\"vfb-desc\">Direct Line <\/label><input type=\"tel\" name=\"vfb-110\" id=\"vfb-110\" value=\"\" class=\"vfb-text  vfb-medium   phone \" \/><\/li><div id=\"item-vfb-111\" class=\"vfb-section-div \"><h4>Subject Information<\/h4><\/div><div class=\"vfb-clear\"><\/div><li class=\"vfb-item vfb-item-text   vfb-left-third\" id=\"item-vfb-112\"><label for=\"vfb-112\" class=\"vfb-desc\">Name of Person  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-112\" id=\"vfb-112\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-date   vfb-middle-third\" id=\"item-vfb-113\"><label for=\"vfb-113\" class=\"vfb-desc\">Date of Birth <\/label><input type=\"text\" name=\"vfb-113\" id=\"vfb-113\" value=\"\" class=\"vfb-text vfb-date-picker  vfb-medium  \" data-dp-dateFormat=\"mm\/dd\/yy\" \/><\/li><li class=\"vfb-item vfb-item-text   vfb-right-third\" id=\"item-vfb-163\"><label for=\"vfb-163\" class=\"vfb-desc\">File Number  <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"text\" name=\"vfb-163\" id=\"vfb-163\" value=\"\" class=\"vfb-text  vfb-medium  required  \" \/><\/li><li class=\"vfb-item vfb-item-instructions   vfb-left-third\" id=\"item-vfb-114\"><label class=\"vfb-desc\">(Last Known) <\/label><\/li><li class=\"vfb-item vfb-item-text   vfb-right-two-thirds\" id=\"item-vfb-115\"><label for=\"vfb-115\" class=\"vfb-desc\">Address 1 <\/label><input type=\"text\" name=\"vfb-115\" id=\"vfb-115\" value=\"\" class=\"vfb-text  vfb-medium   \" \/><\/li><li class=\"vfb-item vfb-item-text   vfb-right-two-thirds\" id=\"item-vfb-116\"><label for=\"vfb-116\" class=\"vfb-desc\">Address 2 <\/label><input type=\"text\" name=\"vfb-116\" id=\"vfb-116\" value=\"\" class=\"vfb-text  vfb-medium   \" \/><\/li><li class=\"vfb-item vfb-item-text   vfb-right-two-thirds\" id=\"item-vfb-117\"><label for=\"vfb-117\" class=\"vfb-desc\">Town \/ State \/ Zip Code <\/label><input type=\"text\" name=\"vfb-117\" id=\"vfb-117\" value=\"\" class=\"vfb-text  vfb-medium   \" \/><\/li><li class=\"vfb-item vfb-item-phone   vfb-left-third\" id=\"item-vfb-118\"><label for=\"vfb-118\" class=\"vfb-desc\">Phone 1 <\/label><input type=\"tel\" name=\"vfb-118\" id=\"vfb-118\" value=\"\" class=\"vfb-text  vfb-medium   phone \" \/><\/li><li class=\"vfb-item vfb-item-phone   vfb-middle-third\" id=\"item-vfb-119\"><label for=\"vfb-119\" class=\"vfb-desc\">Phone 2 <\/label><input type=\"tel\" name=\"vfb-119\" id=\"vfb-119\" value=\"\" class=\"vfb-text  vfb-medium   phone \" \/><\/li><li class=\"vfb-item vfb-item-checkbox  vfb-three-column \" id=\"item-vfb-120\"><label class=\"vfb-desc\">Please Specify Which Services Are Needed <\/label><div><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-120[]\" id=\"vfb-120-0\" value=\"Criminal Records\" class=\"vfb-checkbox  \" \/><label for=\"vfb-120-0\" class=\"vfb-choice\">Criminal Records<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-120[]\" id=\"vfb-120-1\" value=\"Residency History\" class=\"vfb-checkbox  \" \/><label for=\"vfb-120-1\" class=\"vfb-choice\">Residency History<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-120[]\" id=\"vfb-120-2\" value=\"Property Ownership\" class=\"vfb-checkbox  \" \/><label for=\"vfb-120-2\" class=\"vfb-choice\">Property Ownership<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-120[]\" id=\"vfb-120-3\" value=\"Driving History\" class=\"vfb-checkbox  \" \/><label for=\"vfb-120-3\" class=\"vfb-choice\">Driving History<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-120[]\" id=\"vfb-120-4\" value=\"Bankruptcies\/Liens\" class=\"vfb-checkbox  \" \/><label for=\"vfb-120-4\" class=\"vfb-choice\">Bankruptcies\/Liens<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-120[]\" id=\"vfb-120-5\" value=\"Civil Judgements\" class=\"vfb-checkbox  \" \/><label for=\"vfb-120-5\" class=\"vfb-choice\">Civil Judgements<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-120[]\" id=\"vfb-120-6\" value=\"Asset Check\" class=\"vfb-checkbox  \" \/><label for=\"vfb-120-6\" class=\"vfb-choice\">Asset Check<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-120[]\" id=\"vfb-120-7\" value=\"Police Reports\" class=\"vfb-checkbox  \" \/><label for=\"vfb-120-7\" class=\"vfb-choice\">Police Reports<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-120[]\" id=\"vfb-120-8\" value=\"Professional Licenses\" class=\"vfb-checkbox  \" \/><label for=\"vfb-120-8\" class=\"vfb-choice\">Professional Licenses<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-120[]\" id=\"vfb-120-9\" value=\"Business Affiliations\" class=\"vfb-checkbox  \" \/><label for=\"vfb-120-9\" class=\"vfb-choice\">Business Affiliations<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-120[]\" id=\"vfb-120-10\" value=\"Relatives\/Associates\" class=\"vfb-checkbox  \" \/><label for=\"vfb-120-10\" class=\"vfb-choice\">Relatives\/Associates<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-120[]\" id=\"vfb-120-11\" value=\"Phone Number\" class=\"vfb-checkbox  \" \/><label for=\"vfb-120-11\" class=\"vfb-choice\">Phone Number<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-120[]\" id=\"vfb-120-12\" value=\"Degree Verification\" class=\"vfb-checkbox  \" \/><label for=\"vfb-120-12\" class=\"vfb-choice\">Degree Verification<\/label><\/span><span class=\"vfb-span\"><input type=\"checkbox\" name=\"vfb-120[]\" id=\"vfb-120-13\" value=\"Other (Note Below)\" class=\"vfb-checkbox  \" \/><label for=\"vfb-120-13\" class=\"vfb-choice\">Other (Note Below)<\/label><\/span><div style=\"clear:both\"><\/div><\/div><\/li><li class=\"vfb-item vfb-item-textarea  \" id=\"item-vfb-144\"><label for=\"vfb-144\" class=\"vfb-desc\">Please Specify &quot;Other&quot; Requirements <\/label><div><textarea name=\"vfb-144\" id=\"vfb-144\" class=\"vfb-textarea  vfb-medium  \"><\/textarea><\/div><\/li><\/ul>&nbsp;<\/fieldset><fieldset class=\"vfb-fieldset vfb-fieldset-2 verification \" id=\"item-vfb-99\" style=\"display:block\"><div class=\"vfb-legend\"><h3>Verification<\/h3><\/div><ul class=\"vfb-section vfb-section-2\"><li class=\"vfb-item vfb-item-secret\"  style=\"display:block\"><label for=\"vfb-100\" class=\"vfb-desc\">Please enter any two digits <span class=\"vfb-required-asterisk\">*<\/span><\/label><input type=\"hidden\" name=\"_vfb-secret\" value=\"vfb-100\" \/><span class=\"vfb-span\"><input type=\"text\" name=\"vfb-100\" id=\"vfb-100\" value=\"\" class=\"vfb-text  vfb-medium  required {digits:true,maxlength:2,minlength:2} \" style=\"display:block\" \/><label>Example: 12<\/label><\/span><li style=\"display:none;\"><label>This box is for spam protection - <strong>please leave it blank<\/strong>:<\/label><div><input name=\"vfb-spam\" \/><\/div><\/li>\n\t\t\t<li class=\"vfb-item vfb-item-submit\" id=\"item-vfb-101\">\n\t\t\t\t\t\t<input type=\"submit\" name=\"vfb-submit\" id=\"vfb-101\" value=\"Submit\" class=\"vfb-submit \" \/>\n\t\t\t\t\t\t<\/li><\/ul>\n\t\t\t<\/fieldset><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/WP\/wp-json\/wp\/v2\/pages\/735\" \/><\/form><\/div> <!-- .visual-form-builder-container -->\n","protected":false},"excerpt":{"rendered":"<p> &hellip; <a class=\"more-link\" href=\"https:\/\/www.srcpi.com\/WP\/background-check-request-form\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"open","template":"","meta":{"footnotes":""},"class_list":["post-735","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.srcpi.com\/WP\/wp-json\/wp\/v2\/pages\/735","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.srcpi.com\/WP\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.srcpi.com\/WP\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.srcpi.com\/WP\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.srcpi.com\/WP\/wp-json\/wp\/v2\/comments?post=735"}],"version-history":[{"count":1,"href":"https:\/\/www.srcpi.com\/WP\/wp-json\/wp\/v2\/pages\/735\/revisions"}],"predecessor-version":[{"id":737,"href":"https:\/\/www.srcpi.com\/WP\/wp-json\/wp\/v2\/pages\/735\/revisions\/737"}],"wp:attachment":[{"href":"https:\/\/www.srcpi.com\/WP\/wp-json\/wp\/v2\/media?parent=735"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}