Please read the following carefully. Your acknowledgement below is required to be considered for employment. If selected, I authorize The Heathers Senior Homes to inquire of and receive information from my current and former employers and/or professional references as to my character and ability. I agree to release and hold The Heathers Senior Homes, its agents, and my current and former employers and/or professional references harmless from any claims or damages resulting from receipt or use of any of the information described above. Every Heathers employee must adhere to our Uniform Policy. These requirements are in place for safety reasons and out of respect for our residents. The Heathers Senior Homes complies with all applicable Federal and State laws. I certify the information on this application is true and correct. I understand any false statements, misrepresentations, or omissions of fact may result in the rejection of my application or in separation from The Heathers Senior Homes if I become employed. Acknowledgement below represents my online signature. *