                       PRE-EMPLOYMENT CHECKLIST






                                   Date: _






Applicant: _


Position: _


        References Requested:                 Date Received:


        _                                     _


        Interviewed By:                       Approved By:


        _                                     _


Education verified: _


Licensure of certification verified: _
Bonding Company approval: _




Starting Salary $_


Fringe Benefits [list]: 
       _


Effective starting date: _






