By checking, I agree to share my form responses.  I authorize the QCS to contact any and all former employers, educational institutions, law enforcement agencies, city, state, county and federal courts to release information about my background including (but not limited to)  information about past and current employment, education, criminal record and general public records history.

I release from all liability all persons and companies supplying such information. I indemnify Quality Care Services, Inc against Any liability, which may result from making such requests. This release shall remain in effect for the length of my employment.

I understand that any misrepresentation or omission in this application will be sufficient cause for cancellation of the application and/or termination of employment if hired. Upon hire, I will comply with all rules, regulation and policies set forth in QCS's policy and procedure Handbook. 

I understand that this is an application for employment only and not a contract for employment.