High School

College or University

Specialized Training, Trade School, etc.

Other Education

Reference 1

Reference 2

Reference 3

I have applied for employment with the Pacific Education Institute (PEI) and have provided information about my previous employment. My signature below authorizes my former or current employers and references to release the contents of my employment record with their organizations and to provide any additional information that may be necessary for my application for employment to PEI, whether the information is positive or negative.

I authorize PEI to investigate all statements made in my application for employment and to obtain any and all information concerning my former/current employment. This includes my job performance appraisals/evaluations, disciplinary action(s) if any, and all other matters pertaining to my employment history. I knowingly and voluntarily release all former and current employers, references, and PEI from any and all liability arising from their giving or receiving information about my employment history, my academic credentials or qualifications, and my suitability for employment with PEI.

This form may be photocopied or faxed, and these copies will be as effective as a release or consent as the original which I sign.

In exchange for the consideration of my job application by the Pacific Education Institute (“PEI”), I agree that:

Neither the acceptance of this application nor subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other organizational practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of PEI, or otherwise to change in any respect the employment-at-will relationship between them and the undersigned, and that relationship cannot be altered except by a written instrument signed by an officer of PEI. The undersigned or PEI may end the employment relationship at any time for any reasons, with or without cause. If employed, I understand that PEI may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits.

I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice.

I further understand that by submitting this application, I give PEI permission to verify that I meet legal age requirements and that I am legally eligible for employment in the United States.