REFERENCE RELEASE FORM

Please include the names of 2 Supervisors and 1 character reference.

Reference 1

Company Name

Name of Reference

First Name

Last Name

Phone

(###)

###

####

Relationship to you?

How long have you known this person?

Reference 2

Company Name

Name of Reference

First Name

Last Name

Phone

(###)

###

####

Relationship to you?

How long have you known this person?

Reference 3

Company Name

Name of Reference

First Name

Last Name

Phone

(###)

###

####

Relationship to you?

How long have you known this person?

I understand that The Collective will check references, as a part of the hiring process, to learn about my work history. I understand that these references will be confidential. I also understand that I will not have access to them. I release The Collective and all providers of information from any liability as a result of furnishing and receiving this information.

I give permission for the representative of The Collective to contact my current employer for a reference.

Yes

I give permission for the representative of The Collective to contact my past employers as shown on my job application and resume, and those listed above for employment references.

Yes

Failure to authorize contacts may exclude you from being considered for employment.

First Name

Last Name

Recognition of Digital Signature

I agree that my electronic signature is the legally binding equivalent to my handwritten signature, that it has the same validity and meaning as my handwritten signature, and that I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding. By signing the Agreement, I consent to be legally bound by the Agreement's terms and conditions.

I AGREE

Email Address

Phone

(###)

###

####

Date

YYYY