I solemnly swear or affirm that the answers I have made to each and all
of the questions are complete and true to the best of my knowledge and
belief. In the event of employment, I understand that false or misleading
information given in my application or interview(s) may result in discharge.
I hereby waive all provisions of law forbidding my physician or other person
who has attended or examined me, or who may hereafter attend or examine
me, colleges or universities which I attended, or past employers from disclosing
any knowledge or information which they thereby acquired relevant to my
employment and I hereby consent that they may disclose such knowledge or
information to Green Hills Community. I authorize investigation of all
statements contained in this application for employment as may be necessary
in arriving at an employment decision. I understand that this application
is not and is not intended to be a contract for employment.