(Please read the following statements, sign below, and return to the Human Resources office.)

I, ____________, hereby authorize my prior employer, _______________, to release any and all information relating to my employment with them to ________________ (your company's name). I further release and hold harmless both ______________ and _____________ (your company's name) from any and all liability that may potentially result from the release and/or use of such information. I understand that any information released by my prior employer will be held in strictest confidence, that it will be viewed only by those involved in the hiring decision, and that neither I nor anyone else not so involved will have the right to see the information.

__________________________________  __________________

Signature of Employee                             Date


Employee's Name - Printed

[Note to employer - omit this before printing the form: Have the applicant fill out one of these forms for each prior employer from which you intend to seek job reference information. Using the form will make it much more likely that the prior employer will feel at liberty to release the information you request, or at least more than the usual work dates and salary confirmation that are of limited value in the hiring decision. Also keep in mind that if anyone refuses to sign such an authorization, your company would have the legal right to refuse to consider that person any further for hiring.]

The following two topics in the book address the legal issues behind job references and background checks:

References and Background Checks
Job References

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