I verify that the information on this application is true and complete and it is understood and agreed that any misrepresentation or falsification of these facts will be sufficient grounds for dismissal. Furthermore, I understand that just as I am free to resign at any time, the Employer reserves the right to terminate my employment at any time, with or without cause and without prior notice, and that no representative of the Employer has the authority to make any assurance to the contrary.

I authorize the Employer to investigate all references and secure additional job-related information. I release from liability the Employers and it's representative for seeking such information and all either persons, corporations, or organizations for furnishing such information. 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.

The Employer is an equal opportunity employer. The Employer does not discriminate in employment and no question on this application is used for the purpose of limiting or excluding any applicant's decision for employment on a basis prohibited by local, state or federal law.

This application is current for sixty days. At the conclusion of this time, if I have not heard from the Employer and still wish to be considered for employment, it will be necessary for me to fill out a new application.