I certify that the information contained in this application is correct to the best of my knowledge. I understand that falsification of this application in any detail is grounds for disqualification from further consideration or for dismissal from employment in accordance with Company policy.

I agree to conform to the rules and regulations of Michigan Brand (hereinafter "the Company"), and understand that my employment and compensation can be terminated, with or without cause, and with or without notice, at any time, at the option of either the Company or myself. I further understand that no personnel recruiter or interviewer or any other representative of the Company has any authority to enter into a contract of employment except for the Company President, and that any such agreement must be signed by the Company President.

I acknowledge that consideration for employment is contingent on the results of a reference and background check. Therefore, I authorize the Company to: (1) investigate the truthfulness of all statements made on this application; (2) contact my former employers and other listed references or any other persons who can verify information (including law enforcement agencies); and (3) discuss results of any investigation with other employees of the Company involved in the hiring process. In addition, I give my consent for all contacted persons, including former employers, to provide information concerning this application and I release each such person from liability for providing information to the Company. I waive any written notice for the release of such information which may be required under state or federal law.

I acknowledge that a physical examination and drug screen test may be required prior to beginning employment. I authorize any physician or hospital to release any information which may be necessary to determine my ability to perform the duties of the job for which I am applying. I understand that a positive drug test result, a refusal to submit a requested sample for testing, or a refusal to authorize such testing in writing may result in the Company withdrawing any offer of employment made to me.

Michigan law prohibits discrimination in employment based on handicap. However, an applicant or employee requiring accommodations for employment must notify the employer in writing within 182 days after the need is known. Failure to do so shall result in an affirmative defense to the Company based on any claim I might bring for failure to accommodate a disability in the workplace under Michigan law.

I understand that, if hired, this application form, including the acknowledgements I have made above, will become part of my official employment record.