I hereby affirm that the information provided on this application (and accompanying resume, if any) is true and complete. I understand that any false or misleading representa-
tions or omissions made on the application or during the hiring process may disqualify me from further consideration for employment and may result in discharge even if
discovered at a later date.
I understand that employment may be conditioned upon successfully passing a medical examination and that I may be required to satisfactorily complete a drug screening as
a condition of employment.
I hereby authorize persons, schools, my current employer (if applicable) and previous employers and other organizations to provide this facility and its affiliates with any
request- ed information regarding my application or suitability for employment, and I completely release all such persons or entities from any and all liability related to the providing
or use of such information.
I understand that my employment is at-will which means that I may terminate the employment relationship at any time and for any reason with or without notice, and that the
facil- ity has the same right. I understand that no one has the authority to enter into any agreement contrary to the preceding sentence, except for a written agreement signed by an
admin- istrative representative of this facility and notarized.