I certify that the information that I have provided on this application is true and correct and that no attempt has been made to conceal pertinent information. I authorize my former employers, schools, business references and other sources of information to provide any information they may have regarding me. I hereby release them and their company from all liability for divulging same. I authorize any investigation of the above information for purposes of verification. I agree that if any information given by me in this application is found to be false or misleading, I will be rejected or subject to dismissal at any time during the period of my employment, and I agree to hold Urgent Care of Booneville and/or any of its affiliates, and persons named herein blameless on this count. In processing the Application, the employer may request that an investigative consumer report be prepared, which may include information as to my work record, criminal police record, personal characteristics and mode of living. I understand that a criminal report may be requested during the application process or course of my employment to determine if I have been convicted of a felony that has not been expunged or sealed by a court. I understand that I have the right to request that the employer disclose to me the nature, scope and name of agency providing information and that such a request must be made in writing to the Human Resources Department of the employer within a reasonable time after I complete this Application. Further, I understand that my credit and/or my criminal record may be reviewed from time to time. I understand I may be required to satisfactorily complete a screen for illegal drugs prior to consideration for employment. I understand that any offer of employment is conditioned upon the results of these screening examinations. Failure to submit to a screen for illegal drugs or other authorized screens, if requested, may result in termination of employment. I authorize Urgent Care of Booneville and/or any of its affiliates to conduct the screen for illegal drugs and other authorized screenings, and release Urgent Care of Booneville and/or any of its affiliates from any liability or damages arising from the results of these screens. If employment is obtained under this application, I will comply with all rules and regulations of the company. I agree to be responsible for company property and equipment issued me by the company until returned. Further, I understand and agree that my employment is at will and is for no definite period of time and may, regardless of date of payment of my salary or wages, be terminated at any time by me or at the discretion of the employer, in which event, the obligation of the employer shall end with the payment of salary or wages through the last day of employment. I further understand this application or other papers and forms signed do not constitute or imply a contract of employment. I certify that I have read and understand these conditions of employment and agree to abide by these conditions. I understand that the foregoing conditions may not be modified in any manner except by the President of Urgent Care of Booneville and/or any of its affiliates and any modification must be in writing and be signed by the President.