I hereby authorize Selective Case Management, Inc. (SCM) and its representatives to run a
complete background check including, but not limited to education, references, and criminal
history which may be in any state or local files, including those maintained both public and private
organizations for employment purposes.
I specifically authorize my former employers and their representatives to release information
from my personnel file pertaining to performance and the reason for separation. Selective Case
Management, Inc. shall retain the signed copy of this authorization in its files.
I agree information provided is accurate and true. I execute this release with the full knowledge
and understanding that information obtained will be kept confidential, used only for vocational