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I certify that I have read this application and the information on it is complete and correct. I understand that any omissions or misrepresentations of information are grounds for dismissal.

I authorize the persons, employers, schools, and organizations listed on this application to give you any information concerning my employment and other pertinent information they may have, personal and otherwise, and release all parties from all liability and damages that may result from furnishing this to you.

This company is an equal opportunity employer. Various federal, state and local laws prohibit discrimination on account of race, color, religion, sex, age, national origin, disability or veteran's status, or other categories protected by law. It is this company's policy to comply fully with these laws, as applicable, and information requested on this application will not be used for any purpose prohibited by law.