Educational Reference Check Letter 12 Check Request Form

Company Letterhead

{{company_name}}

{{company_address}}

Phone: {{company_phone_number}}

Email: {{company_email}}

Website: {{company_website}}

Date of Request

{{date_of_request}}

To: HR/Verification Department

Please initiate an educational background check for the candidate listed below. All necessary information has been provided for this request.

Candidate Information

Candidate Full Name: {{candidate_full_name}}

Candidate ID/Reference Number: {{candidate_id_number}}

Position Applied For: {{position_applied_for}}

Date of Birth: {{candidate_date_of_birth}}

Contact Number: {{candidate_contact_number}}

Email Address: {{candidate_email_address}}

Educational Institution Details for Verification

Name of Institution: {{institution_name}}

Type of Qualification (e.g., Degree, Diploma, Certificate): {{qualification_type}}

Major/Field of Study: {{major_field_of_study}}

Dates of Attendance (From): {{attendance_start_date}} (To): {{attendance_end_date}}

Date of Graduation/Completion: {{graduation_date}}

Student ID Number (if known): {{student_id_number}}

Institution Contact Person (if known): {{institution_contact_person}}

Institution Contact Email/Phone: {{institution_contact_details}}

Authorisation

I confirm that the candidate has provided explicit consent for this educational background check, as per the signed {{candidate_consent_form_reference}}.

Verification Details

Please verify the following:

1. Confirmation of qualification awarded.

2. Dates of attendance and graduation.

3. Major/Field of Study.

4. Any other relevant academic achievements or disciplinary records (if applicable and permissible by law).

Urgency/Priority

Standard: ☐

Urgent: ☐ (Reason: {{urgency_reason}})

Additional Notes/Specific Instructions

{{additional_notes}}

Reporting

Please send the completed verification report to: {{reporting_email_address}} by {{report_due_date}}.

Signature Block

Requested By: ___________________________

Name: {{requester_name}}

Title: {{requester_title}}

Department: {{requester_department}}

Date: {{request_signature_date}}