I declare that the above information and statements are true
and that I have not knowingly withheld any facts that would,
if disclosed, affect my application unfavorably. I understand
that if Boyd's Kinsman Home discovers
significant inaccuracies or omissions in the above information
and statements, I may be denied employment or, if already
employed, I may be discharged. By signing this application I
understand that Boyd's Kinsman Home will be
contacting my present and/or past employers and character
reference should I be considered for employment.
hereby authorize BOYD'S KINSMAN HOME to make any
investigation of my prior employment or educational history. This
information will assist them in their
assessment of my qualifications. I also give permission to
BOYD'S KINSMAN HOME to contact the
persons I named in order to complete a personal reference check.
I hereby authorize my present and past employers and schools that I
have attended to release any and all employment information and any
other confidential information that BOYD'S KINSMAN HOME may
I understand that any information released by my prior employer or
school will be held in strictest confidence, that it will be viewed
only by those involved in the hiring decision, and that neither I
nor anyone else not so involved will have the right to see the
information. I specifically indemnify BOYD'S KINSMAN HOME and
the person(s) contacted from any and all claims of libel or slander
arising out of the completion of this reference check.
I have carefully read and reviewed all the provisions above and have
voluntarily agreed to sign this authorization.
PLEASE RETURN COMPLETED APPLICATION TO BOYD'S KINSMAN HOME