By Submitting this application, I certify that the facts contained in this application are true and complete to the best of my knowledge, and understand that, if employed, falsified statements, as well as misrepresentation or omissions, on this application may result in termination.

I authorize investigation of all statements contained in this application for any employment-related purpose. I release the listed references and all employers, except those specifically excepted below, to provide you with any and all applicable information they may have. I hereby release these references and former employers from all liability for any information they may give to you.