(PLEASE READ VERY CAREFULLY)
I understand and voluntarily agree that:
  1. The information that I have provided on this application is true and complete to the best of my knowledge. Any misrepresentation or omission of any fact in my application, resume, or any other materials, or during any interviews can be justification for refusal of employment, or, if employed, termination from CHSI's employ.
  2. Any offer of employment I may receive from CHSI is contingent upon my successful completion of the CHSI's total preemployment screening process, including CHSI's receiving references that it considers satisfactory, and my satisfactory completion of any post-job offer preemployment physical examination that CHSI may require.
  3. I understand that as a condition of employment, I may be required to undergo and successfully pass a screening for alcohol and/or drugs. I also understand and agree that, if employed, I may be required to submit to an alcohol or drug screening at any time at the discretion of CHSI.*
  4. In processing my application for employment, CHSI may verify all the information provided by me, or may procure or have prepared a consumer or an investigative consumer report for this purpose concerning, among other things, my prior employment or military record, education, character, general reputation, personal characteristics, criminal record, and mode of living. I understand that upon written request to CHSI, I will be informed of whether an investigative consumer report was requested and given full information as to the nature and scope of this investigation.**
  5. I authorize and request that all of my present and former employers and those individuals I have listed as personal references furnish information about my employment record, including a statement of the reason for the termination of my employment, work performance, abilities, and other qualities pertinent to my qualifications for employment, hereby releasing them from any and all liability for damages arising from furnishing the requested information.
  6. In consideration of my employment, I agree to comply with the policies, rules, regulations, and procedures of CHSI and understand that my employment and compensation can be terminated with or without cause or notice, at any time, at the option of either CHSI or me. I further understand that no manager or representative of CHSI, other than the President, General Counsel, or Vice President has any authority to enter into any agreement with me for employment for any specified period of time or to make any agreement different from or contrary to any CHSI policy. I further understand that any such agreement, if made, shall not be enforceable unless it is in writing and signed by me and by one of the individuals designated above.
* Employers should note that state and local laws vary with respect to the right of an employer to conduct random drug tests on employees. In this connection, check with employment law counsel before engaging in such testing.

** Certain state fair credit reporting acts are more stringent than the federal act. Employers who use consumer or investigative reports in the employment process should consult with counsel about state requirements.
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