Ref #: HR-000

Beaconhouse School System Rev: 00

Date: 05-01-2015
Security Clearance & Reference Check Form

Branch/Office: ___________________ Employee ID (for existing staff only) _________ Date: __________

Position Applied/Offered (for new staff only):_______________________________

*The position offered is subject to the completion of this form and successful reference check.

PERSONAL INFORMATION
Full Name (in block letters):______________________________________________________________
S/O-D/O-W/O:_________________________________________________________________________
Previous Name (if any) - also reason for change: ______________________________________________
(*Kindly attach proof i.e. Newspaper cutting)
Date of Birth: ____________ _ Religion: ________________ Nationality: _________________

CNIC No.: - -
Visible Marks of Identification: ____________________________________________________________

Permanent Address:
Urban Area Rural Area
House/ Street No: Village/ Post Office
Sector/ Mohalla/ Block: Street No:
City: City/Tehsil/ District:
Police Station: Police Station:
Province: Province:
Telephone No (s): Telephone No (s):
*Incase of rented house, please attach lease/rent agreement.

Present Address (if different from mentioned above): ________________________________________

_____________________________________________________________________________________
Police Station: ______________________________
Province: _________________________ Contact No (s): ______________________________________
*Kindly bring in proof of address (preferably last 3 months paid utility bills)
Employee Signatures:__________________________
*This signature validates that all information provided above is correct and may be verified by Beaconhouse School System.

Reference (Professional)

Name: _______________________________________________________________________________
Email: ______________________________________ Contact No._______________________________
Address: _____________________________________________________________________________

CNIC No.: - -

Relationship: _________________________________ Remarks:________________________________

Signature: __________________________ Date:______________

*This signature validates that all information provided above in professional reference is correct.
 Ref #: HR-000
Beaconhouse School System Rev: 00
Date: 05-01-2015
Security Clearance & Reference Check Form

Reference (Personal)

Name: _______________________________________________________________________________
Email: ______________________________________ Contact No._______________________________
Address: _____________________________________________________________________________

CNIC No.: - -

Relationship: _________________________________ Remarks:________________________________

Signature: __________________________ Date:______________

*This signature validates that I know the person and all information provided above in personal reference is correct.

For office use

Original CNIC Seen Yes No

Paid Utility Bill seen Yes No

Car/ Motorbike registration number and original papers seen Yes No

*Copies of the above documents need to be attached with this form.

Remarks (if any):

_____________________________________________________________________________________
_____________________________________________________________________________________

Security and reference check cleared  Yes No Signed by: ______________________________

Name: _________________________________

Designation: ____________________________

Date: __________________________________