I certify that my answers are true and complete to the best of my knowledge. I authorize Northwest Community Action, Inc. to make such investigations and inquiries of my personal employment, or educational and other related matters as may be necessary for an employment decision. I herby release employers, schools or persons from all liability in responding to inquires in connection with my application.

In the event I am employed, I understand that false or misleading information given in my application or interview(s) may result in discharge.

Please read the information below carefully and completely

With my application for employment with Northwest Community Action, Inc. I authorize Northwest Community Action, Inc. to conducted reference checks from either previous or current employers.

I further authorize Northwest Community Action, Inc. and have provided employment references for which Northwest Community Action, Inc. is being authorized to conduct reference checks with my previous or current employer. It is to my understanding that the employment reference checks may either be verbal or written inquiries of employment performance, professional demeanor, rehire eligibility, dates of employment and salary.

My signature below authorizes my previous or current employer references to release information regarding my employment record with their company and may provide additional information that is related to my application for employment with Northwest Community Action, inc.