Background Check Information
All information is to be filled out by applicant only.
The individual filling out this document must be over the age of 18.
Please Print and Complete All Questions - Incomplete Information May Result In Automatic Rejection.
First Middle Last
Current Address: __________________________________________________________________________
Street/No. City State Zip
Daytime Telephone: (______)_______-___________ ext:________
Cell Phone: (______)_______-___________ Evening Telephone: (______)_______-___________
Have you committed a felony, been charged with a felony or are currently charged with a felony?_________
Have you committed a misdemeanor, been charged with a misdemeanor or are currently charged with a
PLEASE READ THE BELOW TERMS AND CONDITIONS CAREFULLY
dallasmm reserves the right to conduct a criminal background check and use all other relevant information
in this application to review the applicant’s character. This application is not binding as to whether the
acceptance into dallasmm’s match program is guaranteed to the applicant. dallasmm has every right on
whether to reject or accept the potential applicant.
I hereby certify that the statements made in this application have been examined by me and are true, correct and
complete to the best of my knowledge. I have no objection to the inquiries to be made in the future for the purpose
of verifying the facts herein stated or determining the qualifications of my application. I understand that the filing of
this application in no way obligates dallasmm to accept or deny me into the program.
Signature of Applicant Date
dallasmm criminal background check