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Original 2026-01-01
Modified 2026-02-21
1 <h2>Become a Client</h2>
1 <h2>Become a Client</h2>
2 <p><strong>To learn more about our services or to become a client, please complete the form below. A Universal Background Screening representative will contact you as soon as possible.</strong></p>
2 <p><strong>To learn more about our services or to become a client, please complete the form below. A Universal Background Screening representative will contact you as soon as possible.</strong></p>
3 <p>* These fields are required.</p>
3 <p>* These fields are required.</p>
4 <p>First Name: *</p>
4 <p>First Name: *</p>
5 <p>Last Name: *</p>
5 <p>Last Name: *</p>
6 <p>Company: *</p>
6 <p>Company: *</p>
7 <p>Title:</p>
7 <p>Title:</p>
8 <p>Phone: *</p>
8 <p>Phone: *</p>
9 <p>Fax:</p>
9 <p>Fax:</p>
10 <p>Email: *</p>
10 <p>Email: *</p>
11 <p>Street:</p>
11 <p>Street:</p>
12 <p>City:</p>
12 <p>City:</p>
13 <p>State/Province:</p>
13 <p>State/Province:</p>
14 <p>Zip:</p>
14 <p>Zip:</p>
15 <p>Country:</p>
15 <p>Country:</p>
16 <p>How did you learn about us?:</p>
16 <p>How did you learn about us?:</p>
17 <p>Referred By:</p>
17 <p>Referred By:</p>
18 <p>Number of Employees:</p>
18 <p>Number of Employees:</p>
19 <p>Number of Screens per Month:</p>
19 <p>Number of Screens per Month:</p>
20 <p>Industry:</p>
20 <p>Industry:</p>
21 <p>Applicant Tracking System:</p>
21 <p>Applicant Tracking System:</p>
22 <p>Interested in the following services:</p>
22 <p>Interested in the following services:</p>
23 <p>Additional Comments:</p>
23 <p>Additional Comments:</p>
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