Screening Assistance Request Form

New Hire's Last Name

New Hire's First Name:

Special Notes:

Acknowledgement 1:

I acknowledge and understand that VF Business Group, Inc. will lend me the money that is needed to schedule my Fieldprint Background Screening Appointment.

Acknowledgement 2:

I acknowledge and agree to use the money that VF Business Group, Inc. lends me for the sole purpose of scheduling my Fieldprint Background Screening Appointment. within no more than 3-business days of receiving the funds

Acknowledgement 3:

I acknowledge and understand that VF Business Group, Inc. will recoup the money that was loaned by withdrawing the funds over three pay periods (e.g. $30 per paycheck)

Acknowledgement 4:

I acknowledge and agree to repay the loan that was given to me by that VF Business Group, Inc. within a 30-business day period regardless of whether I successfully pass my background check or not.

New Field:

By checking this box, I acknowledge that I have read and agree to the terms listed above.