I hereby authorize Main Street Veterinary Hospital to verify all the information I have provided to obtain and disclose all personal information or all information regarding my person. This verification may be performed by phone or in writing, notably but not exclusively, before personal information agents, former employers, associations, current employers, public agencies, para-public agencies, and or any other source I provide below as a reference.
I authorize the individuals and organizations named below to furnish any and all information requested by the company listed above and/or its representatives, on its behalf, free of all and any liability.
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.