| Authorization
"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 statments on this application shall be grounds for dismissal.
I authorize investigation of all statments 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 the utilization of such information.
I also understand 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 in writing and signed by an authorized company representative.
This waiver does not permit the release or use of this ability-related
or medical information in a manner prohibited by the American with Disabilities
Act (ADA) and other relevant federal and state laws."
By checking this box I agree with the terms and conditions outlined in
this form.
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