PLEASE READ EACH PARAGRAPH CAREFULLY BEFORE INITIALING

I have disclosed all information that is relevant and should be considered applicable to my candidacy for employment. I understand, where permissible under applicable state and local law, I may be subject to a pre-employment drug test after receiving a conditional offer of employment, and must receive a negative result for illegal drug use before being permitted to commence work with Company. I understand, where permissible under applicable state and local law, I may be subject to a pre-employment background check after receiving a conditional offer of employment to investigate my criminal background and other matters related to my suitability for employment.

I hereby certify that the information given by me is true in all respects. I authorize Company and its representatives to contact my prior employers and all others (with the exception of my current employer if I have marked 'May we contact your present employer' on this applicable as 'No') for the purpose of verification of the information I have supplied, and release same from any liability resulting from the information released. I authorize, employers, schools and other persons named on this application to provide any information or transcripts requested.

Applicant's Statement

I certify that all of the above information is true and complete, and I understand that any falsification or omission of information may disqualify me from further consideration falsification or omission of information may disqualify me from further consideration before discovery. Note: An offer of employment is conditioned upon complying with Company's requirements including, but not limited to, signing a consent to conduct a background investigation. I AGREE, AND IT IS MY INTENT, TO SIGN THIS EMPLOYMENT APPLICATION BY CHECKING THE 'I ACCEPT' BOX BELOW AND BY ELECTRONICALLY SUBMITTING THIS DOCUMENT TO COMPANY, I UNDERSTAND THAT MY SIGNING AND SUBMITTING THIS DOCUMENT IN THIS FASHION IS THE LEGAL EQUIVALENT OF HAVING PLACED MY HANDWRITTEN SIGNATURE ON THE SUBMITTED DOCUMENT.