I certify that the above information is true and correct to the best of my knowledge and understand that any false information on this form is cause for discharge if later hired. I also understand that I must complete all information requested or the application may not be processed.

I authorize the company to verify the information on this form through my employers and other references. I realize that if a conditional offer of employment is made, I must successfully complete a substance abuse screening test.

I understand if I am hired, it will be on an employee-at-will basis. I further understand that no statement, oral or written, by any company employee is sufficient to alter the at-will relationship, except for a notice in writing signed by an officer of the Company.