Please read the following text carefully before signing.
As part of our procedure for processing your employment application, your personal and employment references may be checked. If you have misrepresented or omitted any facts on this application, and are subsequently hired, you may dismissed from your job. You may make a written request for information derived from the checking of your references.
If you are hired, you will be required to supply your birth certificate or other proof of authorization to work in the US.
I hereby certify that to the best of my knowledge and believe the answers by me to the forgoing questions and all statements made by me in the application are correct.