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DISCLOSURE FORM
In connection with my application for employment with For Stars Catering (including contract for services), I understand that investigative background inquiries may need to be made concerning myself, including consumer reports, investigative consumer reports, criminal, driving and other reports. These reports may include information as to my character, credit worthiness, general reputation, personal characteristics, mode of living, work habits, performance and experience, along with reasons for termination of past employment from previous employers. I have a right to request disclosure of the nature and scope of the report, which involves personal interviews with sources such as neighbors, friends, or associates. I authorize, without any reservation, any party or agency contacted by this employer or its agent to furnish the above-mentioned information:
Print Full Name: _____________________________________________
Social Security Number:_____/_____/_____ *Date of Birth:_________
Current Address: ____________________________________________
City/State/Zip: ______________________________________________
Drivers License Number: ______________________ State: _________
*Date of Birth is being requested in order to obtain accurate retrieval of records. APPLICANT/EMPLOYEE’S HOLD HARMLESS STATEMENT I authorize my previous employer to furnish For Stars Catering any and all information requested in any pre-employment questionnaire that is received by said previous employer. I further promise to hold said previous employer, its employees and officers harmless for any statements made therein.
Signature:_____________________________ Date:____________________
Please print this form, fill it out and sign it. Then fax it, email or mail it to us. Thank you.
For Stars Catering, Attention: Human Resources
214 Main Street #149, El Segundo, California 90245
Phone: (310) 322-1972; Fax (562) 922-8028
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