Start with the most current employer and include U.S. Military Service.

I voluntarily give Elcor the right to make a thorough investigation of my past employment, military duty, references and convictions. I agree to cooperate in such investigation and release from all liability or responsibility all persons, companies, schools, organizations, agencies or corporations supplying such information. This information may include verification of employment dates, salary, as well as performance evaluations, reason for termination, eligibility for rehire, attendance record and conviction record. This authorization includes any organizations and/or persons with which I have an affiliation as named above. I also do hereby state that I have never been discharged by an employer for patient/child negligence or abuse. Further, I have never been found guilty of patient/child negligence or abuse in any situation. I certify that answers given herein are true and complete. I authorize investigation of all statements contained in this application for employment and copies of this application as may be necessary in arriving at an employment decision.