As a part of our volunteer process, you must successfully complete a background check. In order to make this process quick and easy, Delta Sigma Theta Sorority, Inc. requires that you complete the following request. By providing this information electronically it can be safely and securely transmitted to our background check vendor instantly. This enhanced process can remove days of waiting from the overall process. Please remember to do the following:

1) Complete all fields

2) Use your legal name and information and add any maiden or previous names to the additional names section

3) Review your answers for accuracy and spelling

4) If you have any questions or special circumstances you should call our office at 919-812-2770 before submitting this request.

Thank You,
Juanita Massenburg
SOUTH ATLANTIC REGIONAL DIRECTOR
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Last Name
First Name
Middle Name
Maiden Name
Federal EIN Number
Street Address of Residence
City of Residence
State of Residence
Zip Code of Residence
Region of Residence
Country of Residence
Government ID
Date of Birth: mm/dd/yyyy
Social Security Number
Hire Date: mm/dd/yyyy
Citizenship Status
Employee Signature Date
Alien Identification (Registration) Number
Alien I-94 (Admission) Number
Alien Authorized to work until
Document Type
Issuing Authority
Document Number
Expiration Date (if any): mm/dd/yyyy
Preparer Name
Preparer Address
Preparer City
Preparer State
Preparer Zip Code
Preparer Date: mm/dd/yyyy
Company Name
Employer Name
Employer Phone
Employer Title
Employer Address
Employer City
Employer State
Employer Zip Code
Review Name
Question
Answer
Reference Code
Second Reference Code
Jobid
Package Name
Degree Type
Verification Type
School
Location
Company City
Company State
Company Zipcode
Company Country
Name (First Last) While Enrolled
Degree
Major
Start Date
End Date
Graduation Date
gpa
Company Name
Company Location
Company City
Company State
Company Zipcode
Company Country
Phone Number
Position
Start Date
End Date
Company Contact
Name of Reference
Relationship
Phone: 555-555-5555
Reference Type
Custom Question
Email
Organization Name
License Type
License Number
State
Received on Date: mm/dd/yyyy
Expires on Date: mm/dd/yyyy
Company Name
Company Location
Phone Number
Position
Start Date
End Date
Company Contact
Landlord/Management Company
Property Name
Property Address
Monthly Rent
Phone Number: 555-555-5555
Fax Number: 555-555-5555
Rental Start Date
Rental End Date
License
State
County
Years to Search
District
Country
Location
Reason For Test
Applicants Phone: 555-555-5555
Regulation Type
Ext
Credit Type
Spouse First Name
Spouse Middle Name
Spouse Last Name
Spouse SSN