APPLICANT CERTIFICATION OF INFORMATION
I certify that all information I have provided in order to apply for and secure work with the employer is true, complete and correct.
I understand that any information provided by me that is found to be false, incomplete or misrepresented in
any respect, will be sufficient cause to (i) cancel further consideration of this application, or (ii) immediately
discharge me from the employer’s service, whenever it is discovered.
I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact
and obtain information from all references (personal and professional), employers, public agencies, licensing
authorities and educational institutions and to otherwise verify the accuracy of all information provided by me
in this application, resume or job interview. I hereby waive any and all rights and claims I may have regarding
the employer, its agents, employees or representatives, for seeking, gathering and using such information in
the employment process and all other persons, corporations or organizations for furnishing such information
about me.
I understand that the employer does not unlawfully discriminate in employment and no question on this
application is used for the purpose of limiting or excusing any applicant from consideration for employment
on a basis prohibited by applicable local, state or federal law.
I understand that this application remains current for only 30 days. At the conclusion of that time, If I have not
heard from the employer and still wish to be considered for employment, it will be necessary to reapply and
fill out a new application.
If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice,
and the employer reserves the same right to terminate my employment at any time, with or without cause and
without prior notice, except as may be required by law. This application does not constitute an agreement or
contract for employment for any specified period or definite duration. I understand that no supervisor or
representative of the employer is authorized to make any assurances to the contrary and that no implied oral
or written agreements contrary to the foregoing express language are valid unless they are in writing and
signed by the employer’s president.
I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in
the United States and that federal immigration laws require me to complete an I-9 Form in this regard.
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