Identify three persons who know your work, beginning with the most recent. We prefer three
business references, not personal.
Authorization and Acknowledgements
I affirm that the information I have provided in this application is true to the best of my
knowledge, information, and belief, and I have not knowingly withheld any information
requested. I understand that withholding or misstating any information requested in this
application is grounds for rejection of my application, and that providing false or misleading
information in this application is grounds for discharge.
I authorize the company to verify my references, record of employment, education records, and
any other information I have provided. Unless otherwise noted, I authorize the references I have
listed to disclose any information relating to my work record and my professional experiences
with them, without giving me prior notice of such disclosure. In addition, I release the company,
my former employers and all other persons and entities, from any and all claims, demands or
liabilities arising out of or in any way related to such inquiry or disclosure.