Application Form Waiver

Please read each paragraph carefully

I hear by certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or any other 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.

I hereby authorize Cross Roads Case Management to thoroughly investigate my references, work records, education, driving record, criminal background and other matters related to my suitability for employment. I further authorize the employers, schools and other references I have listed to disclose to Cross Roads Case Management any and all documents, transcripts, letters, reports and other information related to these references, without giving me prior notice of such disclosure. I hereby release Cross Roads Case management my former employees, 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 investigations or disclosures.

I understand that nothing contained in the application, or conveyed during any interview which may be granted, or during my employment, if hired, is intended to create an employment contact between me and Cross Roads case management, other than one that is “at will”. I understand and agree that if I am employed, my employment and be of an “ at will” nature, whereby either the employee or the employer may terminate the employment relationships at any time, with or without cause or notice. I further understand that my employment, if hired, is for not definite or determinable period of time and may be terminated at any time, at the option of either myself or Cross Roads Case Management, and that no promise or representation contrary to foregoing is binding on the company unless made in writing and signed by me and the company’s designated representative.