I certify that I have read, fully completed this form and that the information herein is correct to the best of my knowledge. I authorize the references listed on this form to give Rich's Car Wash any and all information concerning my previous employment and pertinent information they may have, personal and otherwise. I understand that any omission or false information is ground for dismissal. I understand that as a part of the procedure for my employment application, an investigative report may be made concerning my character, general reputation, personal characteristics and mode of living.