I authorize present and former employers, and individuals I have listed as personal references, to furnish information about my employment record, including a statement of the reason for the termination of my employment, work performance, abilities, and other qualities pertinent to my qualifications for employment, herby releasing them from any and all liability for damages arising from furnishing the requested information.

I certify that the information contained in this application is correct to the best of my knowledge. If employed, I understand that the falsification of this information may result in my dismissal. I authorize the investigation of all statements contained in this application for employment as necessary in arriving at an employment decision. I understand that my employment may be terminated, with or without notice, by the Company for any reason, including lack of work, unsatisfactory performance, improper behavior or any other reason which, in the sole judgment of the Company, constitutes a basis for termination of employment.