Employment Reference Release
As I may use {INSERT COMPANY NAME} ("the Company") as a future reference in employment situations, I hereby authorize {INSERT COMPANY NAME} to disclose any employment related information that {INSERT COMPANY NAME}, in its sole discretion and judgment, may determine is appropriate to any companies, persons, or educational institutions that I have authorized to contact the Company. Such employment related information may include, but is not limited to, employment dates, job duties, opinions regarding job performance and salary and wage rates.
I agree to release and discharge {INSERT COMPANY NAME} and {INSERT COMPANY NAME} successors, employees, officers, and directors for all claims, liabilities, and causes of action, known or unknown, fixed or contingent, that may result from the disclosure of employment related information to prospective employers. This release includes, but is not limited to, claims of defamation, libel, slander, negligence, or interference with contract or profession.
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