I certify that the facts contained in this application are true and complete to the best of my knowledge. I understand
that, if employed, falsified statements on this application shall be grounds for immediate dismissal.
I authorize investigation of all statements contained herein and the references/employers 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 form all liability for any damage that may result from utilization of such information.
I acknowledge that, if I become employed, I will be free to terminate my employment at any time for any reason
and Tess Oral Health retains the same rights. No Tess Oral Health representative has the authority to make any
contrary agreement. This application does not establish an employment contract.