| References
- List the names of three persons
not related to you, whom you have
known at least one year. |
|
"
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 grounds
for dismissal.
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.
I also undertand and agree that 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 written and
signed by an authorized company 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."
|
| Date: |
Digital
Signature: (name:)
|
