6125 Bosque Blvd. Waco, Texas 76710 (254) 772-2122
I hereby affirm that all information provided in this application is true and accurate to the best of my knowledge and understand that any deliberate falsifications, misrepresentations, or omissions of fact may be grounds for rejection of my application or dismissal from subsequent employment.
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concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all such parties from liability or any damage that may result from furnishing this information.