CERTIFICATION OF APPLICANT
I certify that all answers to the questions in this application are true and I further understand that any false statement in this application will be sufficient grounds of rejection of the application or termination of employment/volunteer status without notice at any time hereafter. I authorize Ampersand Sexual Violence Resource Center of the Bluegrass to complete a criminal background check if I have applied to a position subject to this requirement. I understand that the findings of a record check may be grounds for rejection of application or termination of employment/volunteer status without notice. I authorize the Ampersand Sexual Violence Resource Center of the Bluegrass to make all necessary investigations to verifying information contained herein, and authorize and release from liability and and all references to provide information relevant to my application for employment or volunteering.
I certify that my electronic signature is the equivalent of my manual signature on this document.