Acknowledgement Of Disclaimer And Employment Application

I, THE UNDERSIGNED, certify that the information contained in this application is correct to the best of my knowledge. I understand that to falsiiy iniormation is grounds for refusing to hire me, or ior discharge should I be hired.

I authorise any person, organization or company listed on this application to furnish any and all information concerning my previous employment, education and qualifications for employment. I also authorise to request and receive such information.

In consideration for my employment, I agree to abide by the rules and regulations of which rules may be changed, withdrawn, added or interpreted at any time, at the company's sole option and without prior notice to me. I also acknowledge that my employment may be terminated, or any oifer or acceptance of employment withdrawn; at any time, with or without cause, and with or without prior notice at the option of the company or myself,

Signed and dated this _________ day of ________ 20 _.

_________________________

Signature - Undersigned

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