As an applicant for a position with the City of Nyssa, I am requested to furnish information for use in determining my qualifications and suitability to fill the position. I understand that any or all information contained in my application for employment may be subject to verification or investigation by the City. I also understand that criminal history and driving records will be checked if, in the judgment of the City such are relevant to the position for which my application for employment is made.
For these purposes, I consent to the release of information concerning my qualifications, suitability, and moral character by employers, education institutions, law enforcement agencies, and other relevant individuals and agencies to any duly authorized agent of the City of Nyssa. Such release includes any personnel or investigative files maintained by former employers.
I further consent to allow a photocopy of this release form when presented by a duly authorized agent of the City of Nyssa to serve as valid release even though the photocopy does not contain an original writing of my signature.
I hereby release, discharge and exonerate the City of Nyssa, Oregon its agents and representatives, and any and all agencies, organizations or individuals, or representatives thereof so furnishing information, from any and all liability of every nature and kind arising out of the furnishing or inspection of such documents, records, and other information pursuant to the Release of Information.
This release will expire one year after the date it is signed.