Contract Packs / All Documents / Applicant Consent to Release Information

Instructions: In order to consider an application for employment with Company Name, each applicant must authorize Company Name to make inquiries. This consent form allows Company Name to gather the required information from the parties listed during the application process. You must be at least 18 years of age to agree to this consent form. If you are not at least 18 years of age, you must additionally get a parent or guardian to sign this form in the space provided below.

I, First Last, authorize Company Name to inquire and request information about my educational qualifications and past employers. I also understand that the results of these inquiries shall be made available to Company Name and become part of my permanent record with Company Name. I hereby authorize any Company Name-approved staff or third-party designee to conduct such inquiries and I authorize all past employers, educational institutions, service organizations, volunteer groups, or any other organization or certifying body to release information to Company Name.

The following information is approved for release:

• Any information requested by Company Name
• Date(s) of employment
• Salary history and compensation
• Position held or title(s)
• Job description(s) and area(s) of responsibility
• Attendance / absenteeism information
• Degrees obtained / credits earned / transcripts

Insert Social Security Number / TIN / ID. Date when the contact was signed.

Parent or Guardian Signature:

Human Resources Department