I certify that the information given herein is true and complete to the best of my knowledge. I authorize to make such investigations and inquiries of the information provided herein, and other matters related hereto, as may be necessary. I hereby release employer, schools, and other persons, institutions or businesses from all liability in responding to inquiries in connection with my application. I understand that false or misleading information given in my application or during interviews may result in a refusal to hire, or discharge in the event of employment.
113 First Street West
Conover, NC 28613
910 Burkemont Avenue
Morganton, NC 28655
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