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IMPORTANT! By checking the box below I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that if employed falsified statements on this application shall be ground for dismissal.

I authorize investigation on 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 might have, personal or otherwise and release the company from all liability for any damage that might result from utilization of such information.

I also understand and agree that o 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 contact to the foregoing unless it is in writing and signed by an authorized company representative.