Fillable Employment Verification Form printable pdf download

Employment Verification Form

Employee Directions: Sign and date the employee authorization below. Send this form to your previous employer for

completion.

EMPLOYEE AUTHORIZATION: I hereby authorize the individual, company or institution named below to furnish New

Hanover County Schools with validation of my previous work experience. I release this individual, company or institution

and all individuals connected therewith, including New Hanover County Schools, from any and all liability whatsoever

that might otherwise be incurred in furnishing such information.

___________________________________________________

___________________________________

Last 4 digits of Social Security #

Print Employee Full Name

________________________________________________

___________________

Signature of Employee

Date

Previous Employer Directions: The individual listed above is currently employed by New Hanover County Schools and

desires to obtain validation of previous work experience from your company. In accordance with the release signed by the

individual above, please provide the information requested below and return directly to: New Hanover County Schools,

Human Resources-OWE, 6410 Carolina Beach Road, Wilmington, NC 28412. FAX: 910-254-4471

Name of Company: _____________________________________ Business Phone: ______________________

Street Address: _____________________________City, State, Zip: ____________________________________

Position Employee Held with Your Company:______________________________________________________

Dates of Prior Employment: From: __________ To: __________ Avg. Hours Worked per week: _____________

Brief Description of Duties and Responsibilities:____________________________________________________

___________________________________________________________________________________________

Person Completing Form (Print):_______________________________Your Title/Position:__________________

Signature:___________________________________ Date: _______________________

Your signature affixed above, indicates the information provided to us concerning this individual is, to the best of your knowledge, accurate and

truthful.

Rev. 02/01/2014

Employment Verification Form