If you were able to qualify for this opportunity, would any of the following be a problem?
Previous Employment (please list most present first)
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 this application could be grounds for dismissal. I authorize investigation of all statements and agree references listed above may give any information regarding my ability for employment. I release all parties from all liability for any damage that may result from furnishing this information.