This certifies that this application was completed by me, and that all entries on it are true and complete to the best of my knowledge. I understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize representatives of Benjamin Lawn and Landscape, LLC (BL&L) to make such investigations and inquires of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. I release the BL&L from all liability for any damage that may result from utilization of such information. This waver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws. *
Please type name and date below if you agree.