By checking box below, I hereby certify that 1) all my answers are true and complete; 2) that I have never had a professional license/registration revoked, limited, suspended or denied; 3) that I have never been convicted of fraud, convicted of a related crime, or convicted of theft or embezzlement. I authorize employer to make a thorough investigation of my past employment and all other facts stated on the application and authorize all corporations, companies, former employers, educational institutions, law enforcement agencies, city, state, count and federal courts, and other persons from whom information may be sought to release information they may have about me to this employer or their agent and release all parties involved from any liability and responsibility for doing so. I realize falsification, omissions, or other misrepresentation by me on this application may be cause for rejection or dismissal. I understand hiring is subject to satisfactory completion of 1) references; 2) accuracy of pre-employment information furnished; 3) compliance with Immigration Reform Control Act of 1986; 4) other legitimate criteria as established by employer. I understand that the shift, days, nature, and facility location of my employment are subject to change, based on the needs of the company. I further understand that if an employment relationship is established between company and me such employment shall be at will and I have the right to terminate my employment at any time for any reason and company retains the same right. I also understand that no employee, manager, or representative of company can orally modify or make promises altering the at-will nature of my employment. Furthermore, any employment offer will be reduced to a formal, written document signed by a representative from company’s Management Team.