Application for Employment

List below last four employers, starting with your present or last place of employment.
You may include in such history any verified work performed on a volunteer basis.

List the names of three persons not related to you, whom you have known at least three years.

Signing this application, I certify that all of the foregoing information is a complete and accurate statement of the facts. I understand that if any misrepresentation, omission or falsification be discovered, it will constitute grounds for dismissal. I hereby authorize you to conduct any investigation necessary concerning any part of my background related to the position I am seeking. I release all parties from any liability in connection with the provision and use of such information.
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This application is current for only 60 days. At the conclusion of this time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to fill out a new application.

I understand and agree that, if employed by this organization, I will abide by its rules and regulations which I understand are subject to change. I further understand that, if hired, my employment is for no definite period of time and may be terminated by either party at any time.