APPLICANT’S CERTIFICATE AND RELEASE
I certify that all information I have provided in order to apply for employment with
Liberty Nursing Agency, Inc. is true, correct, and complete, including the information
in this application. I understand that any information provided by me that is found to
be false, incomplete, or misrepresented in any respect may result in (a) no further
consideration of this application, or (b) my immediate discharge by Liberty Nursing
Agency, Inc. when it is discovered.
I expressly authorize, without reservation, Liberty Nursing Agency, Inc. to conduct
any reference or background checks which it, in its sole discretion, deems appropriate
and authorize it to obtain information form an employers, public agencies, licensing
authorities, educational institutions, organizations or person, and to otherwise verify
the accuracy of all information provided by me in this application, my resume or
during the interviewing process.
I hereby release Liberty Nursing Agency, Inc. and its employees, agents and affiliates
from any and all liability relating to conducting or obtaining any reference or
background checks, including my criminal background history, and the use of such
information. I further release all employers, public agencies, licensing authorities,
educational institution, organizations and persons from all liability in responding to
any reference checking , or criminal background inquiries by or on behalf of Liberty
Nursing Agency, Inc.
If I am hired by Liberty Nursing Agency, Inc. I acknowledge that Liberty Nursing
Agency, Inc. reserves the right to terminate my employment at any time, with or
without cause and without prior notice, except as may be required by law. This
application does not constitute an agreement or contract for employment for any
specified period or definite duration. I understand that no employee, agent or
representative of Liberty Nursing Agency, Inc. is authorized to make any assurances
to the contrary and that no implied, oral or written agreements contract to the
forgoing express language are valid unless they are in writing and signed by Liberty
Nursing Agency, Inc.'s staffing coordinator.