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I agree a co py or facsimile of this authorization may serve as an original. Complete Signature of Applicant Date Month Day Year Please print your full name APPLICANT S AGREEMENT I understand that misrepresentation omissions of facts or incomplete information requested may result in my not being consi dered for employment. List any special certifications etc. Other Information or Explanation PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY Conditions of Employment AUTHORIZATION TO RELEASE...
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