Application for Employment

I certify the facts contained in this application are true and complete to the best of my knowledge and understand, if employed, falsified statements on this application shall be grounds for dismissal.

I also understand and agree no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized representative.

This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the americans with Disabilities Act (ADA) and other relevant federal and state laws.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.