Please list three professional references.
Disclaimer and Signature
Pre-Employment Background Release Form
I hereby authorize the release for pre-employment screening to include: A background check, driving record, or any other information (criminal, credit, driving, workers-comp, education history, as well as information regarding my general character and/or reputation) to help the above said parties in determining my employment.
I release any providers of such information from any liability for providing the same. I understand the information may be reviewed initially and reported to my prospective/actual employer.
I agree that falsification may result in ineligibility for employment or subject to immediate dismissal, if hired. I further acknowledge the release to: my prospective employer, their prospective owners, officers, agents, and employees from any and all liability arising out of errors or omissions.
If not hired based on the report, I understand I have rights under FCRA (Fair Credit Reporting Act) laws including the right to review my report and correct errors.
Date of Birth: