New Employment Application

Employment Application: Surveillance Investigator (Houston, TX)

Applicant

First Name:

Last Name:

Address:

Address(cont):

City:

State: Zip Code:

Home Number:

Cell Number:

Email:

Referral

If you were referred by someone working for VRC please enter their name, otherwise enter where you found out about this position

Referred By:

Employment Experience

Starting with your present or last job. List the past 10 years of employement history. If additional space is needed please click the add another button. Please include this information on your resume.

Previous Employer:

Employer:

Address:

City:

State:

Supervisor:

Your Title:

Employment Dates:

From:

To:

Reason For Leaving:

Starting Salary:

Ending Salary:

Job Description:

Authorization for Release of Information

(This language was tested and upheld in Smith v. Holley, 827 S.W. 2nd 433 (Tex.App.-San Antonio 1992). Note that this is a release for conducting in-house background and reference checks. When receiving information through a third party consumer reporting agency, the Fair Credit Reporting Act requires a separate disclosure and consent form. The consumer-reporting agency will supply employers with the appropriate forms to use.)

I hereby authorize any investigator or duly accredited representative of Veracity Research Company, bearing this release to obtain information from schools, residential management agents, employers, criminal justice agencies, or individuals, relating to my activities. This information may include, but is not limited to, academic, residential, achievement, performance, attendance, personal history, disciplinary, arrest, and conviction records.

I hereby direct you to release such information upon request of the bearer. I understand that the information released is for official use by Veracity Research Company and may be disclosed to such third parties as necessary in the fulfillment of official responsibilities.

I hereby release any individual, including record custodians, from any and all liability for damages of whatever kind or nature which may at any time result to me on account of compliance, or any attempts to comply, with this authorization.

Veracity Research Company is an "At-Will" employer

I have read/understand and authorize Veracity Research Co. Investigations to conduct a verification of the information submitted including the release of information as part of a normal employment application process.

I authorize the release of information

School Level	School Name	Years Attended	Graduated	Major or Degree Earned
High School
Vocational or Technical
College or University

Name	Address	Relationship	Phone Number

Employment Application: Surveillance Investigator (Houston, TX)

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