Please list last four employers, starting with your present or most recent work.
Please name three persons not related to you who are able to rate your qualifications.
Please read carefully before signing
The answers and statements given by me to the foregoing questions are true and correct without consequential omissions of any kind. I understand that any falsification contained in this information shall be sufficient cause for rejection of this application and/or discharge. I authorize the companies or persons named above to give any information regarding me or my employment.
I hereby accept the rules and regulations of the company, now in force or that may be established in the future as not arbitrary and will conduct myself in accordance with them, with full knowledge that violation may mean discharge. I also agree to devote my full time to the best interests of the company.
In making this application for employment, it is understood that an investigative report may be made whereby information is obtained through personal interviews with third parties, such as family members, business associates, financial sources, friends, neighbors, or others with whom I am acquainted. This inquiry includes information as to my character, general reputation, personal characteristics, and mode of living, whichever may be applicable. I have the right to make a written request within a reasonable period of time for a complete and accurate disclosure of additional information concerning the nature and scope of the investigation.