BELL TRUCKING CO., INC.
P O BOX 238
SHOEMAKERSVILLE, PA 19555
1-800-345-4115
 

 

 

I, ________________________________, AUTHORIZE RELEASE OF ALL INFORMATION FROM MY PAST EMPLOYERS AND / OR USIS (DAC) CONCERNING DATES OF HIRE, SAFETY INFORMATION, AND DRUG & ALCOHOL TESTING INFORMATION (INCLUDING PRE-EMPLOYMENT TESTING RESULTS) TO BELL TRUCKING CO., INC.
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DATE		 ______________________________
SIGNATURE

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PLEASE FAX THIS RELEASE BACK TO
JERI / BELL TRUCKING
(610) 562-8959

OR SCAN & E-MAIL TO
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