Reference Authorisation Form

Authorization for Pre-Hire Reference Check

Position*

I have applied for a position through AginCare Group As part of a client’s hiring process, AginCare Group may conduct an employment verification, education verification, driver’s license check, criminal background check, reference check, and/or other inquiries regarding my background and employment history, including information as to my personal character, general reputation, job performance, and other qualities pertinent to my prospective service. I hereby consent and authorise AginCare Group and/or their designated agents to make such inquires, and I authorize without reservation, the release of such information to their client and/or their designated agents, and release engage Partners and the provider of such information from any and all liability for damages arising from the investigation and disclosure of the requested information. I will allow a photocopy/fax/email copy of this authorisation to be as valid as the original.

Yes
No

Candidate's Name

First Name*

Last Name*

Signature*

Today's Date*

Today's Date