Please enter your name above if you agree with the below statement -
THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND I HAVE NOT WITHHELD ANY FACT OF CIRCUMSTANCE THAT COULD, IF DISCLOSED, AFFECT MY APPLICATION UNFAVORABLY. I UNDERSTAND THAT ANY FALSE OR MISLEADING STATEMENT OR ANY MATERIAL OMISSION IN THIS APPLICATION OR IN MY PHYSICAL EXAMINATION WILL BE GROUNDS FOR REJECTION OF MY APPLICATION OR (IF I HAVE BEEN HIRED) FOR MY IMMEDIATE DISMISSAL.
I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED IN THIS APPLICATION, INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT, AND ANY OTHER INFORMATION, PERSONAL OR OTHERWISE. I UNDERSTAND THAT I HAVE THE RIGHT TO MAKE A WRITTEN REQUEST WITHIN A REASONABLE PERIOD OF TIME TO RECEIVE ADDITIONAL INFORMATION ABOUT THE NATURE AND SCOPE OF ANY SUCH INVESTIGATIVE REPORT THAT IS MADE. I RELEASE ALL PARTIES FROM LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM FURNISHING INFORMATION AND OPINIONS TO THE COMPANY. I RELEASE AND INDEMNITY THE COMPANY AGAINST ANY LIABILITY THAT MAY RESULT FROM MAKING SUCH AN INVESTIGATION.
IF HIRED, I CONSENT TO TAKING PHYSICAL EXAMINATIONS AND TESTS REQUIRED BY THE COMPANY.
I CONFIRM THAT NO PROMISE REGARDING EMPLOYMENT (OR THE TERMS AND BENEFITS THEREON) HAS BEEN MADE TO ME AND I UNDERSTAND THAT NO SUCH PROMISE OR COMMITMENT WILL BE BINDING UPON THE COMPANY UNLESS IT IS MADE IN WRITING AND SIGNED BY THE ADMINISTRATOR OF COMPANY. IF AN EMPLOYMENT RELATIONSHIP IS ESTABLISHED, I UNDERSTAND THAT I HAVE THE RIGHT TO TERMINATE MY EMPLOYMENT AT ANY TIME AND THAT THE COMPANY RETAINS A SIMILAR RIGHT.