I certify that the information contained in this application is correct to the best of my knowledge.
I understand that to falsify information is grounds for not using my services.
I authorize any person, organization or company listed on this application to furnish you any and all information concerning my previous employment, education and qualifications for my consideration.
I also authorize you to request and receive such information. For consideration of my services, I agree to abide by the rules and regulations of the company, which rules may be changed, withdrawn, added or interpreted at any time, at the company's sole option and without prior notice to me.