Please start with most recent position.

List 3 references who are NOT related to you by blood or marriage.

I acknowledge filling an application for Inspired Senior Healthcare. I hereby authorize Inspired Senior Healthcare to contact any educational institution, former employer, law enforcement agency or reference concerning my background and information provided by me in connection with my application for employment. I hereby authorize the release of such information and release providers of information from all liability in responding to inquiries about me. I understand that this application is not a contract for employment. If an employment relationship is established, I understand that such employment is at-will. I certify that my answers are true and complete to the best of my knowledge. I understand that misrepresentation, omission or falsification of information connected with my application for employment (including résumé) will be sufficient cause in and of itself for disqualification from employment opportunities or dismissal from employment when discovered.