I certify that the information contained in this application is correct to the best of my knowledge and understand that falsification of this information is grounds for dismissal in accordance with filling memorial home of mercy policy. I authorize the references listed to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from liability for any damage that may result from furnishing that same to you.
In consideration of my employment, i agree to conform to the rules and regulations of filling memorial home of mercy and my employment and compensation can be terminated, with or without cause, and or without notice, at any time, at the option of either filling home or myself.
I understand that no supervisor or representative of filling memorial home of mercy other than the executive director of the filling home has any authority to enter into an agreement for employment for any specified period of time or to make any agreement contrary to the foregoing.
I agree that any claim or lawsuit relating to my service with filling home or any of its subsidiaries must be filed no more than one hundred eighty (180) days after the date of employment action that is the subject of the claim or lawsuit. I waive any statute of limitations to the contrary.