Personal Information

Employment Desired

Education

Reference 1:

Former Employer 1:

Authorization:

"I certify that all the information submitted by me on this application is true and complete and I understand that if any false information omission or misrepresentation are discovered, my employment may be terminated at any time. In consideration of my employment, I agree to conform to the company's rules and regulations, and that I agree that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at wither my or the company's option. I also understand and agree that the terms and condition of my employment may be changed, with or without cause and with or without notice, at any time by the company. I understand that no company representative, other that its President, and then only when in writing and signed by the president, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the forgoing."