Skill, Training, and Rehabilitation Service
Concerns Report
Fill out this form ONLY for any concerns you have that for S.T.A.R.S.
Disclaimer and signature
I certify that the answers given by me in this application are correct to the best of my knowledge I understand that any falsification of this application whether willingly or accidental is grounds for disqualification of employment consideration or dismissal from employment if I am hired. I authorize STARS, Inc. to contact any and all of the references I have listed above to obtain previous employment information or any other pertinent information that they may have. Further I release the above-mentioned references from any and all liability for any damages that may result form information collected by this company. Verification of eligibility to work in the United States must be satisfied for an offer to be made.