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Antelope Valley Union HSD |  E  4112.6  Personnel

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Authorization For Release Of Confidential Information

Pursuant to the provisions of California Labor Code 1053, I ____________ hereby expressly authorize any officer, agent, employee, Superintendent or designee or manager representing a former employer to respond to any oral or written inquiries regarding my past performance and general character as a former employee.

I further understand and agree that this authorization will permit my former employer to provide any information regarding my performance including, but not limited to, performance or evaluation reports or other related documents maintained for all employees.

I further understand that in sighing this authorization for release of confidential information, I expressly waive the provisions of Government Code 5254(c) and California Constitution Article I, Section 1 relating to privacy and agree to hold my former employer harmless from the release of any information pursuant to this request.

Date Signature of Person Granting Release

Exhibit ANTELOPE VALLEY UNION HIGH SCHOOL DISTRICT

version: October 1988 Lancaster, California