I hereby affirm that the information provided on this application (and accompanying resume, if any) is true and complete to the best of my knowledge. I also agree that any falsified information or significatn omissions may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date. I authorize a thorough investigation of my past employment, activities, general character, agree to cooperate in such investigations, and release from all liability or responsibility all persons and corporations requesting or supplying such information. I further agree to authorize any physician or hospital to release any information which may be necessary to determine my ability to perform the job for which I am being considered or any future job in the event that I am hired. I hereby agree to submit to lawful drug, alcohol or integrity testing that may be required as a condition of employment or continued employment and understand that refusal to submit such testing during the course of my employment may result in disciplinary action, including discharge. I understand that according to the Immigration Reform and Control Act of 1986 all individuals who are hired must, as a condition of employment, produce certain documentation to verify their identity and legal authorization to work in the U.S. As a consequence, I understand that nay offer of employment is contingent on my ability to produce the required documentation within the time period required by law. I understand that my employment is terminable-at-will, that I am not being employed for any specific time, that this application is not a contract, nor is intended to be a contact for continued employment, and that either the employer or I may terminate my employment at any time with or without cause or notice. Applications may be kept on file for up to twelve months. The employer, however, makes no representation that the application will be reviewed for any other position than the original opening for which the applicant has applied. If the applicant wants to be considered for any other position or opening, he or she should contact the employer directly.

The undersigned applicant authorizes all former employers to provide a complete employment reference and to disclose any information regarding my past employment, including but not limited to my attendance, attitude, potential, and overall performance with said employer. I hereby release any previous employer, and this prospective employer, with whom I have made an application for employment any claims and liabilities either arising from the request for, or release of such employment informatio