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By submitting this form, you certify that the facts contained in this application are true and complete to the best of your knowledge and understand that if employed, falsified statements on this application shall be grounds for dismissal.

You also authorize investigation of all statements contained herein and the references and employers listed above to give any an all information concerning your 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.

Additionally, you 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.