I hereby certify that the above information and responses, as well as any resume furnished by me to Palmer Group, are accurate, correct, and true. I understand that any misstatements of fact, or material omission of fact, may cause Palmer Group to discontinue referrals on my behalf. I acknowledge that completion of this form does not obligate Palmer Group to further process my application.
I hereby authorize Palmer Group to investigate fully my employment, educational, credit, and/or criminal history and any other matters deemed reasonable or necessary by Palmer Group and consent to the disclosure or dissemination by any persons, firms, organizations, or entities (whether public or private) of any and all such information requested.
I hereby release Palmer Group and any of its subsidiaries, affiliates, owners, officers, directors, employees, or agents from any and all claims, causes of action, or damages of any type or kind, whether known or unknown, arising from or in any way related to the investigation or obtaining of information by Palmer Group as set out above. I hereby further release any and all employers, educational institutions, credit reporting agencies, courts, police departments or other entities possessing criminal history information, and any other person, firm, organization, or entity (whether public or private) from any and all claims, causes of action, or damages of any type or kind, whether known or unknown, arising from or in any way relating to the disclosure or dissemination of any and all such information about me or responding to inquiries in connection with this, my application for employment.