I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information that they have personal or otherwise and release all parties from all liability for any damage that may result from furnishing same to you.

I understand that any falsified statements on this application shall be grounds for dismissal. I also understand and agree that my employment is for no definite period and may regardless of the dates of payment of my wages and salary, be terminated at any time without any prior notice.

This certifies that this application was completed by me, I have read and agree to all terms herein, and that all entries on it and information in it are true and complete to the best of my knowledge.