Signature / Certification

I certify that the facts set forth in this application are true, complete and correct to the best of my knowledge. I understand that any misrepresentation, falsifications or omissions on this application can be grounds for rejection of my application or, if I am employed by this company, for my immediate termination from employment. I authorize Loving Hands Homecare, LLC, to make any necessary inquiries and investigations into my education, military or employment history. I further authorize, unless otherwise indicated on this application, the release of my information at Loving Hands Homecare, LLC., by any of the schools, services or employers listed on this application.