The University of Wisconsin-Stout (UW-Stout) is committed to ensuring a safe campus environment for students, employees and visitors through the performance of criminal background checks. A criminal background check is part of a general background review on potential employees and volunteers. Except as otherwise provided in the policy, a criminal background check must be performed on each new hire for a UW-Stout position.

**International background checks may incur a delay in processing as well as additional charges.

For more information please refer to the UW-Stout Criminal Background Check Policy and the Criminal Background Check FAQ's. If you have any questions or concerns, please contact the Human Resources Office through AskHR.

Please use the form below to request a background check for a new employee or volunteer.


Position Information

Employee Type


Position Title:


TAM Job#


Start Date:

    mm/dd/yy  (only for recruited positions,
not applicable for student positions)

Account to be Charged:


 Second Account:


If background check is being charged to more than
one account, how should the funding be split?


Employee Information

Please use legal name as it appears on social security card.

Employee First Name:


Employee Last Name:


Employee Personal Email:


Is this employee an international hire or has the employee lived outside the United States in the past 5 years?


Requestor Information

First Name:


Last Name:









If someone other than the requestor should be contacted with the results:

First Name:


Last Name: