PLEASE READ CAREFULLY BEFORE FILLING OUT THE EMPLOYMENT APPLICATION AND SIGNING

I certify that the answers giving in this Employment Application are true and complete to the best of my knowledge. The facility may investigate all statements made in this Application. The facility is required by law to check for any criminal or abuse record. I understand that any false or misleading information provided can result in a decision not to hire, immediate discharge if hired, and civil or criminal penalties in appropriate cases. In signing this Application, I state that I have reviewed the Job Description(s) for the job(s) for which I have applied. I understand that the failure to fulfill any aspect of the job may result in termination. I also understand that I may be required to take a physical examination conducted by a physician of the employer's choosing after I am given a qualified offer of employment and that a health screening for diseases, such as tuberculosis (TB), is required. I understand that if hired, I am required to abide by all rules and regulations of the facility.