                        Reference Release Waiver

[]  Have all departing employees sign the following waiver in
conjunction with their Exit Interview.

[Company] policy on providing reference information states that we
only verify:

   Employment Dates
   Job Title
   Location
   Salary

If you wish [Company] to honor requests for additional reference
information (i.e., employment and compensation history with [Company],
performance information, rehire status) indicate your acceptance for
release of such information by completing the remainder of this form.

In addition to the reference information normally verified by [Company]
and stated above, I ask that following information be released upon
written request:
______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________


I, [Employee], in consideration of [Company], agree to allow said
information to be released.  In addition, I hereby release [Company]
from any and all claims by me or through me, either known or unknown,
which may arise from providing the information covered by this
authorization.


__________________________________
[Employee]

_____________
Date

___________________________________
[x] (Name), [x] (Title)
[Company]
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