I certify that all information I have provided in order to apply for and secure work with the
employer is true, complete and correct.
I expressly authorize, without reservation, the employer, its representatives, employees or agents
to contact and obtain information from all references (personal and professional), employers,
consumer reporting agencies, public agencies, licensing authorities and educational institutions and to
otherwise verify the accuracy of all information provided by me in this application, resume or job
interview. I hereby waive any and all rights and claims I may have regarding the employer, its
agents, employees or representatives, for seeking, gathering and using such information in the
employment process and all other persons, corporations or organizations for furnishing such
information about me.
I understand that the employer does not unlawfully discriminate in employment and no question on
this application is used for the purpose of limiting or excusing any applicant from consideration
for employment on a basis prohibited by applicable local, state or federal law.
I also understand that if I am hired, I will be required to provide proof of identity and legal
authority to work in the United States and that federal immigration laws require me to
complete an I-9 Form in this regard.
I agree that any action or suit against the Company, its agents or employees, arising
out of my employment or termination of employment, including, but not limited to, claims arising under State but not Federal, civil rights statutes, must be brought within 180 days of the event giving rise to the claims
or be forever barred unless the applicable statute of limitations period is shorter than 180 days in which case I will continue to be bound by that
shorter limitations period. I waive any limitation periods to the contrary. I further agree that if I should bring any non-statutory action or claim arising
out of my employment against the Company, in which the Company prevails, I will pay to the Company, any and all such costs incurred by the
Company in defense of said claims or actions, including attorney fees.
I understand that any information provided by me that is found to be false, incomplete or
misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of
this application, or (ii) immediately discharge me from the employers service whenever it is discovered.
Do not sign until you have read the above Applicant Statement.
I certify that I have read, fully understand and accept all terms of the foregoing Applicant
Statement. Furthermore, this certifies that this application was completed by me and that all
entries on it and information in it are true and complete to the best of my knowledge.