| If 
                      you are to be hired by the company, you will be required 
                      to attest to your identity and employment eligibility, and 
                      to present documents confirming your identity and employment 
                      eligibility. You cannot be hired if you cannot comply with 
                      these requirements. I certify 
                      that the facts contained in this application are true and 
                      complete to the best of my knowledge. I understand that 
                      any false statement, omission, or misrepresentation on this 
                      application is sufficient cause for refusal to hire, or 
                      dismissal if I have been employed, no matter when discovered 
                      by the Company. I understand 
                      that any employment is conditioned on the background check. 
                      I authorize the Company to thoroughly investigate all statements 
                      contained in my application or resume, and I authorize my 
                      former employers and references to disclose information 
                      regarding my former employment, character and general reputation 
                      to the Company, without giving me prior notice of such disclosure. 
                      In addition, I release the Company, any former employees 
                      and all references listed above from any and all claims, 
                      demands or liabilities arising out of or related to such 
                      investigation or disclosure. I understand 
                      and agree that nothing contained in this application, or 
                      conveyed during any Interview, is intended to create an 
                      employment contract, I further understand and agree that 
                      if I am hired, my employment will be "at will" 
                      and without fixed term, and may be terminated at any time, 
                      with or without cause and without prior notice, at the option 
                      of either myself or the Company. No promises regarding employment 
                      have been made to me, and I understand that no such promise 
                      or guarantee is binding upon the Company unless made in 
                      writing. If 
                      I am offered employment I agree to submit to a medical examination 
                      and drug test before starting to work. If employed, I also 
                      agree to submit to a medical examination or drug test at 
                      any time deemed appropriate by the Company and as permitted 
                      by law. I consent to such examinations and tests, and I 
                      request that the examining doctor disclose to the Company 
                      the results of the examination, which results shall remain 
                      confidential and segregated from my personal file. I understand 
                      that my employment or continued employment, to the extent 
                      permitted by law, is contingent upon satisfactory medical 
                      examinations and drug test, and if I am hired a condition 
                      of my employment will be that I abide by the Company's Drug 
                      and Alcohol Policy. I understand 
                      that filling out this form does not indicate there is a 
                      position open and does not obligate the Company to hire. 
                      If hired, I agree to abide by all Company work rules, policies 
                      and procedures. The Company retains the right to revise 
                      its policies and procedures, in whole or in part, at any 
                      time. By submitting this application you affirm that all information is true and accurate to the best of your knowledge and that you are at least 18 years of age. |