New York State Human Rights Law and Federal Equal Employment Opportunity Law prohibits discrimination because of race, creed, color, national origin, sex, marital status, age, disability or arrest record.

I hereby represent that each answer to a question herein and all other information furnished is true and correct. I further represent that such answers and information constitutes a full and complete disclosure of knowledge with respect to the question or subject to which the answer or information relates. I understand that any incorrect, incomplete or false statements or information furnished by me will subject me to discharge at any time. I hereby authorize my former employers to give any information regarding my employment with them and to furnish any other information they may have concerning me. I understand and agree that my employment is for no definite period and may, regardless of the date of payment of my wages, be terminated at any time without prior notice provided such action is not consistent with any collective bargaining which may govern the wages and conditions of employment of the position in which I am employed. I understand the company reserves the right to unilaterally change or modify wages and conditions of employment at any time, without prior notice, provided such are not subject to collective bargaining. In compliance with the Fair Credit Reporting Act (Public Law 91-508,) you are notified that in connection with and in order to better evaluate this application for employment, a report may be obtained which will provide applicable information regarding character, general reputation, personal characteristics, and mode of living. You have the right to make a written request within a reasonable period of time for a complete and accurate disclosure of the nature and scope of the report requested.