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Islanders Hockey Club
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CORI check form

IHC Staff CORI check Application

Please provide the info below.

Enter phone numbers without spaces or special characters 1234567890 is correct format

For SSO - Provide last 6 (six) digits - No spaces or special characters 123456 is correct format

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IHC CORI / EHF / NEGHL Program Directory Input

IHC Division (East,, Tyngsboro Men, Tyngsboro Women, or Women) *
Choose Men's or Women's Division
       
IHC Team *
Select IHC Team
Staff Position *
Contact Info *
Middle Initial *
Information needed for CORI Check
Contact Address *
City *
State/Zip *
Contact Home Phone - DO NOT USE SPACES OR SPECIAL CHARACTERS *
All numbers - No spaces or special characters - Example 1234567890
Contact Cell Phone - DO NOT USE SPACES OR SPECIAL CHARACTERS *
All numbers - No spaces or special characters - Example 1234567890
Email address *
Type carefully!
The information below is required for CORI Check *
I agree to allow the information to be used for a CORI background check
Suffix *
Jr., Sr. , II, III, or None , etc. (Information needed for CORI Check)
Date of Birth *
For CORI Check - use MM/DD/YEAR - Example 05/29/1965
Last 6 of Social Security Number - Last 6 of Social Security Number - Last 6 of Social Security Number -
Last 6 of Social Security Number
Please provide last 6 (SIX) digits of your social security number
Please provide las 6 (SIX) digits of your social security number
Last 6 Digits of Social Security Number (LAST 6!! - NO SPACES PLEASE: 123456) *
LAST 6 DIGITS - 123456: No spaces or dashes: example 123456
Last 6 of Social Security Number
Last 6 only
Gender (Info required for CORI background check) *
Select Gender