I certify that the answers given herein are true and complete to the best of my knowledge. In applying for employment, I want Neighborhood Health Clinics, Inc.(NHCI)to be fully informed of my work history. I, therefore, authorize NHCI to investigate my background and obtain any and all information that may concern me. I release all persons, including NHCI, schools, companies, corporations, and law enforcement agencies from any liability as a result of furnishing such information. I fully understand that, if employed, any misrepresentation of acts on my application is sufficient reason for my termination. In addition to my authorization and release of information and entities set forth above, I authorize NHCI to discuss the results of any pre-employment investigation with persons who conduct the interview(s) in any investigation as well as with those individuals responsible for hiring. I understand that nothing contained in my application, or in the granting of, or conducting of, an interview is intended to create an employment contractor binding contractual relationship between NHCI and me either for employment or for the providing of any benefit. No promises regarding employment or duration of employment have been made tome, and I understand that no such promises or guarantees are binding upon NHCI unless made in writing by the President/CEO or his/her designee. If an employment relationship is established, I understand that I have the right to terminate my employment at anytime, with or without notice, and for any lawful reason or cause. If any employment relationship is established, inconsideration of such an employment relationship, I agree not to use or reveal any confidential information of NHCI.NHCI and its directors, officers, administrators, managers, employees, and agents are all released by me from any legal responsibility or liability for the release of such information and records as authorized above or any other liability that may arise from the release of such information. I have read the above statement carefully, and I agree to abide by all of the terms set forth above.