Reference Release

I understand that XXX may be checking my references as a part of the selection and hiring process.  I authorize representatives of XXX to conduct a reference with any and all work-related contacts listed on my employment application, with any additional contacts  I provide, and with any other  persons XXX representatives believe could provide relevant information. 

I understand that these references, and the information they provide, will be confidential and that I will not have access to them.  I release XXX and any person or entity that provides reference information to XXX, from any liability that might otherwise arise from the furnishing or receiving of reference information.

Applicant Signature: ________________________________________________

Print Name: ________________________________________________

Date: ________________________________________________