BY SUBMITTING THIS APPLICATION YOU AGREE TO THE FOLLOWING STATEMENTS:

*****APPLICANT'S EMPLOYMENT AUTHORIZATION AND RELEASE STATEMENTS*****

I understand that it is customary for employers to investigate and verify information contained within employment applications and other required employment-related forms. I further understand that any incorrect, incomplete or falsified information on this employment application and other required employment-related forms shall be cause for withdrawal of any offer of employment and termination of employment with COMMUNITY RESIDENTIAL SERVICES, INC.

I hereby authorize the appropriate authorities of COMMUNITY RESIDENTIAL SERVICES, INC., employer, to investigate and verify all information contained within this employment application and other, required, employment-related forms. Further, I hereby release such employer and authorized agents from any and all liability in the obtaining and appropriate use of such information. I realize that any sensitive information obtained shall be treated by COMMUNITY RESIDENTIAL SERVICES, INC. as confidential.

I also understand that i may be required to pass a comprehensive medical examination and/or drug screen tests done by appropriately licensed persons, a fingerprinting background check and to provide acceptable references as conditions of my employment.

If employment is offered by COMMUNITY RESIDENTIAL SERVICES, INC. and I accept such employment, I fully understand that such employment is strictly offered and accepted on the basis of "at-will" employment. "At-will" employment means that an employee may voluntarily resign his/her employment with or without cause at anytime for an nondiscriminatory reason. I understand that all employment-related documents provided to persons employed by COMMUNITY RESIDENTIAL SERVICES, INC. are to be considered and solely interpreted as part of the "at-will", non contractual employment.