I certify that the above is accurate and truthful.  I understand that supplying false or inaccurate information can be grounds for not hiring an applicant, and/or termination.  All application and resume data are subject to verification.

I hereby authorize All Midlands Health Services to verify my education, licenses, motor vehicle records and criminal conviction records.

I also authorize All Midlands Health Services to request, and also authorize each former employer and person given as reference to answer all questions that may be asked, and give all information that may be necessary in connection with this application or concerning me or my work.

Do you agree to these terms? Yes

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All Midlands Health Services is an equal opportunity employer.