Employment
Reference Release
I acknowledge
that I have been informed that it is [Your Business's] general policy to disclose in
response to a prospective employer's request only the following information about current
or former employees: (1) the dates of employment, (2) descriptions of the jobs performed,
and (3) salary or wage rates.
By signing this
release, I am voluntarily requesting that [Your Business] depart from this general policy
in responding to reference requests from any prospective employer that may be considering
me for employment. I authorize [Your Business] to disclose to such prospective employers
any employment-related information that [Your Business], in its sole discretion and
judgment, may determine is appropriate to disclose, including any personal comments,
evaluations, or assessments that [Your Business] may have about my performance or behavior
as an employee.
In exchange for
[Your Business's] agreement to depart from its general policy and to disclose additional
employment-related information pursuant to my request, I agree to release and discharge
[Your Business] and [Your Business's] successors, employees, officers, and directors for
all claims, liabilities, and causes of action, know or unknown, fixed or contingent, that
arise from or that are in any manner connected to [Your Business's] 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.
I acknowledge that I
have carefully read and fully understand the provisions of this release. I further
acknowledge that I was given the opportunity to consult with an attorney or any other
individual of my choosing before signing this release and that I have decided to sign this
release voluntarily and without coercion or duress by any person.
This release sets
forth the entire agreement between [Your Business] and me, and I acknowledge that I have
not relied upon any representation or statement, written or oral, not set forth in this
document.
Signed:
________________________________________ Date: _______________
(Employee)

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