(Please provide the name and phone number of three non-related references that have knowledge of your recent work experience):
Yes I AUTHORIZE INTERCEPT OF FLORIDA OR ITS DESIGNATED AGENTS TO CONDUCT A COMPREHENSIVE REVIEW OF MY BACKGROUND. I UNDERSTAND THIS MAY INCLUDE EMPLOYMENT HISTORY, EDUCATION BACKGROUND, CHARACTER REFERENCES, DRUG TESTING, CIVIL AND CRIMINAL PUBLIC RECORDS. I further authorize any individual, company, firm, corporation, or public agency (including the Social Security Administration and law enforcement agencies) to divulge any and all information, verbal or written, pertaining to me to Intercept of Florida or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation, or public agency may have, to include information or data received from other sources. Intercept of Florida and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicants personal information, including but not limited to, address, social security numbers, and dates of birth. Intercept of Florida is an Equal Opportunity Employer. We are committed to equal treatment of all employees without regard to race, national origin, religion, gender, age, sexual orientation, veteran status, physical or mental disability or other basis protected by law.