Coronavirus (COVID-19) Information

All Hawkeye Community College buildings are closed. Faculty and staff are working remotely and can be reached via email or phone.

COVID-19 Emergency Funds are available to Hawkeye students affected by the disruption of campus operations. Learn more and apply today to see if you qualify!

See the Coronavirus (COVID-19) Information web page for more information. Last updated: Wednesday, May 27, 2020.

Background Check Disclosure and Release Form

As part of the application process for acceptance into a Health and Human Services program at Hawkeye Community College, its agents may conduct an investigation of your personal information.

This investigation may include, but is not limited to:

  • Criminal history records from private, city, state, and federal sources
  • Social security number and/or fingerprint trace
  • Residence history
  • Sex offender and child/dependent adult abuse registries

These records may be used to determine your eligibility and acceptance into Hawkeye's healthcare, police science, and early childhood programs; plus clinical agency and practicum activities.

Background Check Release Form

All fields marked with * are required.

Example: PNN-100-101
Example: 4/1/2020  
Your social security number is needed to process the background check.
(yyyy)




Background Check Disclosure

By submitting this release form, I agree to the following terms:

  • I understand that Hawkeye Community College and its agents may conduct an investigation of my personal information as part of the application process for acceptance into a Health and Human Services program at Hawkeye Community College.

  • I understand that this investigation may include, but is not limited to:

    • Criminal history records from private, city, state, and federal sources
    • Social security number and/or fingerprint trace
    • Residence history
    • Sex offender and child/dependent adult abuse registries.
  • I understand these records may be used to determine my eligibility and acceptance into Hawkeye's healthcare, police science, and early childhood programs; plus clinical agency and practicum activities.

  • I authorize without reservation the full release of these records to Hawkeye Community College and/or its agents contacted to obtain information.

  • I understand that there is a $15, non-refundable, student fee to process the background check.

  • I release and discharge Hawkeye Community College and all of its agents and associates any expenses, losses, damages, liabilities, or any other charges or complaints for the investigative process.

  • I authorize the full release of the information described above, without reservation, throughout the duration of my enrollment at Hawkeye Community College.

  • I certify that, to the best of my knowledge, all information on this release form is correct.

  • I understand any false statements will be considered just cause for dismissal.

  • I understand that I can request that Hawkeye Community College supply me with a copy of my report as pursuant to my rights covered under the Fair Credit Reporting Act.

You will see a confirmation screen once your release form has been submitted. If you do not see a confirmation screen, scroll up and complete missing required information.

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