I hereby make this Applicant Reference Consent and Release (“Consent”).
I hereby give consent to any and all current and former employers of mine to provide information with regard to my employment with such current and former employers to The Alliance Group, Inc. and its employees, agents, and representatives (“Alliance”). I hereby release from liability all current and former employers that provide such information about me, or who participate or assist in any way in the evaluation of my qualifications for future employment.
Without limiting the foregoing, I specifically consent to each such current and former employer providing the following information regarding my employment, and release them from liability in connection with providing such information:
- The dates and duration of my employment;
- My pay rate and wage history as of the date they received this consent;
- My job description and duties;
- The most recent written performance evaluation prepared prior to the date they received this consent which was provided to me during the course of my employment;
- My attendance information;
- The results of drug or alcohol tests administered to me within one year prior to the date they received this consent;
- Threats of violence, harassing acts, or threatening behavior on my part related to the workplace or directed at another employee;
- Whether I was voluntarily or involuntarily separated from employment and the reasons for the separation; and
- Whether I am eligible for rehire.
This consent shall also apply to all current and former employees, agents and other representatives of current and former employers who are authorized to provide, and who do provide, employment information about me to Alliance.
A copy (whether by photocopier, fax machine, or scanner/e-mail) of this Consent shall be as valid and binding as the original.
NOTE: This Consent is valid only during the six (6) month period following the below date. Do not provide information in reliance upon this Consent if more than six (6) months have passed.