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Authorization and Disclosure

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 if I have been employed. 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 had 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 Employer and its representatives for seeking such information and all either persons, corporations or organizations for furnishing such information.

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 only 60 days. At the conclusion of this time, if I have not heard from the Employer and still want to be considered for employment, it will be necessary for me to fill out a new application.