APPLICANT CERTIFICATION AND RELEASE:
I certify that I have read and understand the applicant note on page one (1) of this form and that the answers given
by me to the foregoing questions and the statements made by me are complete and true to the best of my
knowledge and belief.
I understand that any false information, omissions or misrepresentations of facts in this application may result in
rejection of my application or discharge at any time during my employment. I authorize the company and/or its
agents, including consumer-reporting bureaus, to verify any of this information including, but not limited to,
criminal history and motor vehicle driving records. I authorize all persons, schools, companies and law
enforcement authorities to release any information concerning my background and hereby release any said
persons, schools, companies and law enforcement authorities from any liability for any damage whatsoever for
issuing this information. I release this company from any liability which might result from making such
investigations.
I also understand that the use of illegal drugs is prohibited during employment. I am willing to submit to drug
testing to detect the use of illegal drugs prior to and during employment. I understand that this application is not a
contract of employment. My employment is contingent upon confirmation of credentials and successful
completion of drug test or criminal background check. I also understand that if hired, regardless of any oral

presentations to the contrary, the employment relationship between the Company and myself is terminable at-
will, so that both the company and I remain free to choose to end out work relationship at any time for any or no

reason. Any changes in this employment relationship must be made in writing. My signature below acknowledges
that I have read, understand, and agree to the above disclosure. I also understand that due to the nature of the
business, no amount of work can be guaranteed.