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I certify that the facts contained in this application are true and complete to the vest of my knowledfe and understand that, if empl0yed, falsified statements on this application shall be grounds for dismissal.
I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any petinent 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.
I also understand and agree that no representative of the company has any authoroty to enter into any agreement for employment for 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. Yes, I agree to the conditions above. No, I do not agree to the conditions above. Date: Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2005 2006 2007 You will not be able to submit your application if you do not answer "yes" to these terms and conditions.
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