PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING THIS AUTHORIZATION FORM:

I understand that as part of your procedure for processing my application, an investigative report about my background may be made which may include information obtained through personal interviews regarding my character, general reputation, and personal characteristic or mode living. I have the right to make a written request, within a reasonable period of time, for complete disclosure of additional information concerning the nature and scope of the investigation. I authorize investigation of all statements contained in this authorization form. ALL representations by me in this data sheet are to the best of my knowledge and belief true and correct, and I have not knowingly omitted any related information of an adverse nature. Inaccurate information may make me ineligible for employment. I also understand that having a criminal conviction is not an automatic bar for employment. In the absence of a written contract of employment, employment with St. Joseph Villa is employment at the will of each party. The employment relationship may be terminated at any time at the discretion of the employee or St. Joseph Villa.