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#2 Employer Name

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Dates of Employment

#3 Employer Name

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Job Title

Wage

Dates of Employment

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I hereby authorize GW Mechanical, Inc. and its agents to make reasonable inquiry of, and obtain information and records from law enforcement agencies, professional associations, and other entities in order to make an assessment of my character and fitness for the position for which I am applying. In connection with GW Mechanical investigation of my prior work history and character, I hereby wave any and all rights i have against GW Mechanical, Inc. and any of their person's and entities it contacts.

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