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I certify that the information in this application is correct
to the best of my knowledge. I understand that incomplete or incorrect
information may be grounds for refusing to hire or terminating
me if I am hired.
I authorize all schools, former employers, references, and the
state licensing board that have information about me, to provide
such information to the employer and release all parties from
any liability for any damage that may result from providing such
information. I also authorize you (the employer) to request and
receive such information.
I also acknowledge that my employment may be terminated, or any
offer or acceptance of employment be withdrawn, at any time, with
or without cause, and with or without prior notice at the option
of the company or myself.
This application is considered current for 30 days. If you wish
to be considered for later employment, you must renew and update
your application in writing.
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