Reference Release Form

Reference Request

Applicant Name*
First Middle Last
Applicant Release – Reference Request*
- I hereby release from all liability the company or person completing this form, and authorize them to release all information regarding my employment with them. I understand that this information may be released to clients of the requesting company and other requesting third parties on a need to know basis. I also release the requesting company from all liability for any damages from the disclosure of this information.
Signature*
Email*
Date*
MM slash DD slash YYYY