Please read carefully and acknowledge below.
I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment,
and that the answers given by me are true and correct to the best of my knowledge. I understand that any omission, or any
misleading or false information on this application or any attachment to it, or any misleading or false information I present to
secure employment will be grounds for rejection of my application for employment or for immediate discharge from my
employment if I am then employed, regardless of the period of time elapsed before discovery by Pacific Institute for Research and
I hereby authorize and request any present or former employer, school, police department, financial institution or other
entities or persons having personal knowledge about me, to furnish PIRE, or its agents, with any and all information in their
possession regarding me in connection with this application for employment. I agree, if it is requested, that a copy of this
authorization be accepted with the same authority as the original authorization, and I specifically waive that I be provided any
written notice from any present or former employer who is required to notify me in relation to a request for information and who
may provide information based upon this authorized request.
I understand that nothing contained in the application, or conveyed during any interview which may be granted, or during my
period of employment (if I am hired), is intended to create an employment contract between PIRE and me, other than for
employment at-will. In addition, I understand and agree that if I am employed by PIRE, my employment is for no definite or
determinable period and may be terminated at any time, with or without prior notice, and with or without cause, at the option of
either PIRE or me. I also understand that while employment policies or procedures may change from time to time, only a written
agreement signed by PIRE’s CEO, or his designee, and by the affected employee, can change an employee’s employment at-will
I understand that employment with PIRE is conditioned upon my signing and complying with the certification agreement to
comply with the company’s Confidentiality and Non-Disclosure Agreement, and any other policies and procedures provided by
I understand that, if a search of public records (including records documenting a conviction, civil judicial action, tax lien or
outstanding judgment) is conducted by or on behalf of PIRE, I am entitled to a copy of any such public records obtained by the
company, unless I mark the first check box below. If I am not hired as a result of such information, I am entitled to a copy of any
such public records even if I have checked the first check box below.