By submitting this application, I hereby authorize the employers listed above to release all information to Courtyard Estates. I also understand that this authorization is valid for 60 days. I waive any liability to the employers listed above, and its employees, from any claims of action for disclosure of information that could adversely affect any new employment opportunity.
I certify that the above information is true and correct and give authorization for investigation of all
statements and information contained in this application, my resume, and other documents or
verbally obtained information obtained during an employment interview. I voluntarily consent to
allow Courtyard Estates, Aureon, Inc., or any of their representatives or agents to check my
references by contacting any persons, company or governmental entity they deem to be an
appropriate reference. I understand that references questions may pertain to my personal or
educational background, work experiences, character and behavior. I understand my employment is
subject to satisfactory verification of this information and agree that deliberate falsification of this
document or significant omissions shall be grounds for employment consideration disqualification or
dismissal from employment, if discovered at a later date. I pledge, if hired, to comply with the
guidelines of conduct and company policies and procedures of Courtyard Estates. I also realize that
company policies, procedures, practices or statements made during an interview or employment do
not create an employment contract by implication or otherwise. I further understand and agree that
my employment is for no definite period of time and may, regardless of time and manner, be
terminated by the company or myself with or without cause or previous notice. I understand that
employment may be subject to satisfactory completion of physical examination and/or drug
I understand that, if hired, I am entering into a co-employment relationship whereas Courtyard Estates is
my worksite and directing employer, and Aureon, Inc. is my administrative employer. I
agree that the benefit plans offered in my co-employment package are those of Aureon,
Inc. and are the only benefit plans in which I am eligible to participate. I further agree that I will not
be eligible for other benefits (if any) offered to other non co-employees of Courtyard Estates, now or in
the future. I understand, if hired, I may be required to sign a non-compete/non-disclosure
agreement. This application will be kept in a current file for thirty days. If not contacted during that
period of time, it may be necessary to complete another application to receive further employment
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