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The information that you provide on this application is subject to verification. Falsification or misrepresentations may disqualify you from consideration for employment or, if h ired, may be grounds for termination at a later date.
With my signature below (typed), I certify that all information on this is true, correct and complete to the best of my knowledge and contains no willful falsifications or misrepresentations. I authorize all former employers to release job-related information that they may have about me and I release all persons or companies from any liability or responsibility for providing such information.