Background Check Request Form (PER-59)
Fill out the Background Check Request Form (pdf)
The Kansas Board of Regents requires that each state university perform a criminal background check on persons hired for certain state university positions.
Kansas State University is committed to maintaining a safe teaching, learning and working environment for its students, employees and visitors. One aspect of this commitment is to assure, to the extent possible, that appropriate policy and procedures are in place which work toward reducing the likelihood of unknowingly hiring persons with felony or misdemeanor convictions or who are registered sexual offenders.
Completing the Form
- The hiring department makes an offer of employment contingent on the final candidate successfully completing the background check.
- NOTE: refer to information on page one for residents of New York, Minnesota, Oklahoma and California.
- The final candidate (applicant) reads and completes page one of the PER-59.
- Applicant's Last, First and Middle Name
- Other Names/Alias
- Social Security Number
- Date of Birth (mm/dd/yyyy)
- Driver's License Number (complete ONLY for those positions previously authorized by HCS)
- State of Driver's License (complete ONLY for those positions previously authorized by HCS)
- Applicant's Present Address
- Applicant's Telephone #
- Email address of applicant
- The hiring department completes page two of the PER-59.
- Hiring Department/Hiring College
- Position Title
- Position Number
- Indicate type of position (University Support Staff, Unclassified, Graduate position) Driver's License Check? (Yes or No) (ONLY if previously authorized by AVP of HCS)
- Primary Department Contact Person
- Phone Number of primary contact person
- Email address of primary contact person
- Secondary Department Contact Person/phone number/ email address (optional)
- Print all pages of the PER-59. Applicant signs and dates the form. (Applicant must keep the original and all of the attached documents.)
- If the applicant is a resident of California or New York, print the appropriate notice for those states.
- The department faxes or sends a copy of the PER-59 form only (not the attachments) to the Background Check Manager (BCM) by Fax to 785-532-6095 or by mail to Human Resources, 103 Edwards Hall, Manhattan, KS 66506. The entire form includes the first two pages.
- The BCM requests a background check be performed on the final candidate through Validity Screening Solutions on their secure website.
- If the background check is CLEAR on the final candidate, the hiring department will receive an email from the BCM indicating the final candidate is approved for hire and the hiring department may proceed with the hiring process. Hiring department must attach a copy of this email message to the appointment papers submitted to HCS. (If the candidate is being considered for an unclassified position, a representative in the Office of Institutional Equity will be copied on this email sent by the BCM.)
Frequently Asked Questions
Are current employees exempt from the background check process?
If an hourly student employee transfers to a graduate, university support staff, or unclassified position, do we have to do a background check?
If a university support staff employee transfers to an unclassified position, or vice versa, do we have to do a background check?
If we want to hire a former employee, do we have to do a background check?
- Yes, if there has been a break in service for more than one year.
- Yes, if they meet the requirement for international applicants who have been in the U.S. for more than 30 days within the last 7 years and did not have a background check done previously at K-State.
- No, if the break in service has been less than one year for domestic applicants.
If we want to move a temporary employee into a full- or part-time university support staff position, do we have to do a background check?
If we want to hire for a temporary position who will work for about a year, but only a few hours a week, do we have to do a background check?
Yes, since they will be working for more than 6 calendar months.
If an individual is to be employed for less than six (6) calendar months, is then terminated, and soon after reappointed into the same or another temporary position which basically extends their temporary appointment past the six month time frame, do we have to do a background check? (This would also apply to an individual hired for one semester, terminated for the next semester, and then rehired for the following semester.)
Yes. The policy states that background checks are exempted on temporary employees to be employed for six months or less. However, if an individual is to be employed for less than six (6) calendar months, is then terminated, and soon after reappointed into a temporary position which basically extends their temporary appointment past the six month time frame (within the prior 12 months) then a criminal background check will be done.
If you think your temporary appointment will be hired for more than six (6) months, please let us do a background check, so that we comply with Kansas Board of Regents and KSU Policy.
If we are promoting a current regular employee, do we have to do a background check?
For what positions are driving record background checks being done?
Currently, only Extension Agent and Extension Intern positions will have driving records checked.
After a background check has been completed and the hiring department has been notified by email to proceed with hiring for the position, what should we do with any copies of the PER-59?
By law, the department may not keep a copy of the PER-59, and if they do have a copy, it must be destroyed. Only the candidate may keep the original PER-59 form and attached documents.
How would Human Resources know that I have had a background check done on the person that I am hiring?
A copy of the email sent to the hiring department notifying them that the candidate is clear to hire should be attached to appointment papers submitted to HCS.