List Below Four Employers, Starting with the Last one First

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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 in this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and for the references and employers listed above to give you any and all information concerning my previous employment and any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.