CAREER APPLICATION

List all employments for the past 10 years, starting with the most recent position. All information must be completed. You may attach a resume but not in place of completing the required information.

You hereby certify that you have not knowingly withheld any information that might adversely affect your chances for employment and that the answers given by you are true and correct to the best of your knowledge. You further certify that you have personally completed this application.

You understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.

You hereby authorize CHHS to thoroughly investigate your references, work record, education and other matters related to your suitability for employment and, further, authorize the references you have listed to disclose to the company any and all letters, reports and other information related to your work records, without giving you prior notice of such disclosure. In addition, you hereby release CHHS, your former employers and all other persons, corporations, partnerships and associations from any and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.

You understand that nothing contained in the application, or conveyed during any interview which may be granted or during your employment, if hired, is intended to create an employment contract between you and CHHS. In addition, you understand and agree that if you are employed, your employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either yourself or CHHS, and that no promises or representations contrary to the foregoing are binding on the company unless made in writing and signed by you and the CHHS's designated representative.