I certify that all the information contained within this application (and any and all attachments) is
true and correct to the best of my knowledge, and I understand that any false information or
omissions may lead to the rejection of my application or, if I am employed, discipline up to and
including termination at the time any such false information or omission is discovered.
I authorize investigation of all statements contained within this application; authorize Valley
Regional Hospice to secure information about my background and experience with former
employers, educational institutions, and any relevant agencies; and authorize those parties to
provide information to Valley Regional Hospice concerning my background and experience.
I understand that, if I am employed, my employment with Valley Regional Hospice can be
terminated at will, with or without cause, and with or without notice, at any time, either at my
option or the option of the company. I further understand that nothing in this application, or in
any oral or written statement provided to me by Valley Regional Hospice will limit these rights
to terminate my employment at will, and no representative of the company will have any
authority to change this at-will relationship, unless such a change is authorized in writing and
duly signed by the Mari Zakaryan, President of Valley Regional Hospice.
I understand that any offer of employment is conditioned on my providing satisfactory proof of
my identity and proof of eligibility to work in the United States. I further understand that this
application is only valid for the position applied for at present and that Valley Regional Hospice
is under no obligation to retain or consider this application for any future openings.