I voluntarily give this institution the right to make a thorough investigation of my past employment and activities, agree to cooperate in ion. I such investigation and release from all liability or responsibility all persons, companies or corporations supplying such informat con· sent to take the preemployment physical examination, and such future physical examinations as may be required by this institution at such times and places as the institution shall designate.
I understand that I will be required to follow the personnel policies and rules of the institution and that infractions of said rules may lead to dismissal. I also understand that my employment may be terminated for any misstatement or omission of fact appearing on this application form.
I further understand that this institution follows the "fair employment practice code" and there is no discrimination in the hiring of in· individuals based on sex, race, religion, age, or physical or mental handicap unrelated to the ability to perform the work required.
understand that if I am employed it will be on a probationary or trial basis for a period of 90 days. Upon my termination I authorize the I release of reference information on my work.