I affirm that the information contained in this application is true to the best of my knowledge and understand that any statement herein may be verified without causing liability to the Jewish Community Center or the person supplying the information. I give the Jewish Community Center my permission to verify any information in this application, including my work history, reference, general character, and condition of health, and I understand my employment will be contingent upon the center obtaining satisfactory information from the above sources.

I understand that part of this employment application is a release statement that I have signed authorizing private, public, medical institutions, corporations, and or education systems to provide the information as required.

Although management makes every effort to accommodate individual preferences, I recognize that needs may require the following conditions to apply to my position: shift work, rotating work schedules, evening and weekend work. I understand and accept these as conditions of my continuing employment.

I hereby request and authorize any person, company, corporation, organization, agency, institution, government, and private, to release any and all information, including policy, medical, legal, personal, education, or otherwise for records concerning myself to the Jewish Community Center of its authorized agent.

I content and request that all such persons or agencies accept a photocopy of this authorization as valid authorization to give such information or records.

I understand that misrepresentation of the facts or false statements in this application will be cause for the application to no longer be considered, or for my immediate discharge if I am already employed.