(begin with your present or most recent position)

I certify, agree and understand that all information supplied on this application is true and I understand that any untrue statements will be grounds for termination of my employment at any time during my employment. In connection with this application, I authorize all organizations, companies, persons, educational institutions, law enforcement agencies, government departments, current and former employers to release information they have about me and release them from any liability from doing so. I accept the purpose of the information gathering is to determine my suitability for employment. I further understand that appointment is dependent upon: (a) Successful completion of a probationary period, if applicable, (b) Passing applicable testing, where required, (c) My ability to pass a medical examination, where required, (d) Contacting my previous employers to obtain satisfactory reference checks.