I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand that, if I falsify this application or misrepresent or leave out information, I may be refused employment; or, if employed, I will be subject to discharge.

I authorize investigation of all statements contained in this application. I also grant permission to contact all former employers listed above and authorize them to release all information concerning my previous employment. I release all parties from liability for any damage thay may result from furnishing this information to you.

I understand that, as part of my employment, I may be required to take physical and other examinations.

I understand that if employed, just as I may terminate my employment at any time without notice or cause, Parkdale may terminate or modify my employment relationship with it at any time without notice or cause or any reason whatsoever. I further understand that no one at Parkdale, except the President, has the authority to make or enter into contracts of employment or to make any promises or guarantees of continued employment.

I also understand that in order to remain active, this application must be renewed every 30 days.