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I CERTIFY THAT THE INFORMATION GIVEN BY ME IN THIS APPLICATION IS TRUE IN ALL RESPECTS, AND I AGREE THAT IF THE INFORMATION GIVEN IS FOUND TO BE FALSE IN ANY WAY, IT SHALL BE CONSIDERED SUFFICIENT CAUSE FOR DENIAL OF EMPLOYMENT OR DISCHARGE. I AUTHORIZE THE USE OF ANY INFORMATION IN THIS APPLICATION TO VERIFY MY STATEMENTS, AND I AUTHORIZE THE PAST EMPLOYERS, ALL REFERENCES, AND ANY OTHER PERSONS TO ANSWER ALL QUESTIONS ASKED CONCERNING MY ABILITY, CHARACTER, REPUTATION, AND PREVIOUS EMPLOYMENT RECORD AND HISTORY. I RELEASE ALL SUCH PERSONS FROM ANY LIABILITY OR DAMAGES AN ACCOUNT OF HAVING FURNISHED OR REQUESTED SUCH INFORMATION.

I declare the details outlined to be correct to the best of my knowledge and understand that they may form part of my future employment.*

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Cirtronics is a Woman Owned and Employee Owned Manufacturing Services Provider