Applicant Waiver

All applicants must sign and submit with application form

I, THE UNDERSIGNED, hereby certify that the information hereunder is correct to the best of my knowledge and understand that falsification of this information is grounds for refusal to hire or, if hired, dismissal.

I hereby authorise any of the persons or organizations listed in this application to give all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application, and release all such parties from all liability that may result irom furnishing such information to _________________. I authorise to request and receive such information.

In consideration for my employment and my being considered for employment by ____________ I agree to adhere to the rules and regulations of the company and hereby acknowledge that these rules and regulations may be changed by your company at any time, at the company's sole option and without any prior notice. In addition, I acknowledge that my employment may be terminated, and any offer of employment, if such is made, may be withdrawn; with or without prior notice, at any time, at the option of either the company or myself.

I understand that no representative of the company has any authourity to enter into any agreement for employment for any specified period of time, or assure or make some other personnel move, either prior to commencement of employment or after I have become employed. or to assure any benefits or terms and conditions of employment, or make any agreement contrary to the foregoing.

I hereby acknowledge that I have been advised that this application will remain active for no more than ( ) days from the date it was signed.

Signed and dated this ___________ day of ___________ 20 __.

___________________________

Applicant - Undersigned

___________________________

Company Representative

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