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Please fill out this form to complete your authorization request.
Applicant Information
Name
Address
Phone number
Email
Authorization and Consent
I hereby authorize [Your Company Name] and its designated representatives to contact any references I have provided in relation to my application for employment. I consent to the release of information regarding my work history, qualifications, and other relevant details as necessary for the evaluation of my suitability for the position.
I understand that the information obtained will be treated as confidential and will only be used for the purpose of making an employment decision.
Release of Liability
I release all parties involved, including but not limited to the employer, its representatives, and any reference contacted, from any and all liability for providing or receiving this information in good faith and in accordance with applicable laws.
Acknowledgment
I affirm that the information I have provided is true and accurate to the best of my knowledge. I understand that any misrepresentation or omission may result in the withdrawal of my application or termination of employment if already hired.
