In completing and signing this application for employment, I understand the misrepresentations,
false statements or omission of facts is cause for disqualification of this application or disqualification
of the appointment or if I am in the service the COMPANY, disciplinary action, which may include dismissal.
I understand further that information concerning my past record will be sought from my previous employers
and other sources I hereby release from all liability or damages that those individuals, corporation or
organizations who provide information.
I consent by taking a pre-employment medical examination as may be required by the COMPANY.
This certifies that the application was completed by me and that all entries on it and information provided are true and complete on the best of my knowledge.