I represent that the answers and information given by me in the application are true and complete without qualification. I hereby authorize Personal Caregiving Services to verify the same and to make investigation of my background deemed necessary, including any credit check. I authorize former employers law enforcement organizations, educational institutions and any other third party to give Personal Caregiving Services any information they have regarding me without receiving written notice from them. I have no objection to making application for security clearance if necessary, signing an employee agreement on confidential information or taking medical examination. I understand that drug testing is a requirement for employment and Personal Caregiving Services may request a drug test at any tie during my employment in accordance with state and federal law. A positive test may result in termination from my employment. If terminated, I authorize the company to use any information I its possession concerning me for any purpose it deems appropriate including disclosure of information to any third party without notification to me of such disclosure and I release the company from any liability in connection with such use or disclosure.

Furthermore, I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that if employed, falsified statements on the application may result in disciplinary action up to and including discharge from employment regardless of when discovered by Personal Caregiving Services.

I authorize investigation of all statements contained and the references listed above to give you any and all information concerning my previous employment pertinent information they may have personal or otherwise and release all parties from all liability for any damage that may result from furnishing same to you.

I understand and agree that, if hired, my employment is for no definite period and may regardless of the date of payment of my wages and salary, be terminated at any time without prior notice.

Likewise, Personal Caregiving Services can terminate my employment at any time with or without cause, unless otherwise required by law. I further understand that no one other than Personal Caregiving Services has the authority to enter into an employment contract or agreement with me and that my at-will employment can be changed only by a written agreement.

I authorize Personal Caregiving Services to check and verify any and all information listed above, including but not limited to my references, record of employment, education record, and any other information I have provided.

Unless otherwise noted, I authorize the references listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure.</p>

I release the company, my former employers and all other persons and entities, from any and all claims, demands or liabilities arising out of or in any way related to such examination or revelation.

I understand that this application is not a contract, offer or promise of employment and that if hired, I will be an at-will employee. As such, I will be able to resign at any time for any reason.

Likewise, Personal Caregiving Services can terminate my employment at any time with or without cause, unless otherwise required by law. I further understand that no one other than Personal Caregiving Services has the authority to enter into an employment contract or agreement with me and that my at-will employment can be changed only by a written agreement.