Please read and electronically consent to the statement below.* By checking this box and providing my initials below, I am agreeing to the following statement:
CEREBRAL PALSY RESEARCH FOUNDATION OF KANSAS, INC.
APPLICANT ACKNOWLEDGMENT AND RELEASE TO
OBTAIN REFERENCE INFORMATION
READ CAREFULLY BEFORE SIGNING
In signing and submitting this application for employment to you, Cerebral Palsy Research Foundation of Kansas, Inc., (CPRF), I clearly acknowledge and agree that: (1) the information contained in my application for employment is correct and complete to the best of my knowledge and understand that any omission, misrepresentation or falsification of information made therein or in any interviews are grounds for refusal to employ me or my dismissal if I am employed; (2) I authorize the references, schools, and current and past employers I have identified to give the Company any and all information concerning my previous employment and any information they may have, personal or otherwise, and I release all parties from all liability for any damage or claim that may result from furnishing the same to CPRF; (3) if I am employed, I agree to abide by the rules, regulations, and policies of CPRF, and my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at the option of either CPRF or myself; and (4) I understand that no representative of CPRF, other than the President/CEO, has any authority to enter into any agreement for employment for any specified period of time, or make any agreement contrary to the foregoing.