Pre-Employment Screening Payment

Printable Consumer Authorization Form

All fields marked with an * are mandatory.

Name*
First Last
Company (or Company Partenering With)
Phone*
Email*
Service Requested*
- Invoice
- Background Services
Invoice Payment
Invoice Number*
Account Number*
Invoice Amount*
Background Services
In order for any of these services to be run, please have each requestor or applicant fill out the consumer authorization found under the Pre-employment screenings page and submit it to either background@norred.com or fax it to 404-762-4277. Background services may only be completed once both payment and the consumer authorization have been submitted.

Please note that you are entering the quantity and not the price of each service shown below.

For example, if you purchase 3 Drug Screens, your total will be 3 x $39.00.
Nationwide
Price: $18.00 Quantity:
Motor Vehicle Report
Price: $15.00 Quantity:
Drug Screen
Price: $39.00 Quantity:
All Background Services
Price: $71.00 Quantity:
Name of Person(s) the background is for
Additional Instructions or Comments
Payment Info
Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Total Amount Due
If you purchased any background services and the total is not what you expected, please review the quantity of each background service purchased.
$0.00
Credit Card*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
CAPTCHA
Comments
This field is for validation purposes and should be left unchanged.

Invoice Payment