APPLICANT CERTIFICATION & AUTHORIZATION FOR REFERENCE CHECK

1. I authorize the EOC to conduct a reference check with my current and/or previous employer(s), and personal references. I understand that the reference information may include, but not be limited to, inquiries about my employment performance, attendance, and character, rehire potential, dates of employment, and position(s) held.

My signature below authorizes my current or former employer(s) and references to release information regarding my employment record and to provide any additional information that may be necessary for my application for employment to the EOC.

I knowingly and voluntarily release all current and former employers, references, and the EOC from all liability arising from their giving or receiving information about my employment history, academic credentials or qualifications, and my suitability for employment with the EOC.

This form may be photocopied or reproduced as a facsimile, and these copies will be as effective as a release or consent as the original, which I sign.

2. I certify that the answers given herein are true and complete to the best of my knowledge. In the event of employment, I understand that false or misleading information given in my application or interviews may result in discharge no matter how long a time has elapsed since employment.

3. I understand that all hiring commitments are conditional based on the substantiation of information shown on the application; presentation of documents required to verify my legal right to work in the USA; clearance from the authorized Level II background check, and pre-employment health screening, if applicable to the position applied for.

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