|PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY BEFORE SIGNING
THIS APPLICATION. ONLY THOSE APPLICATIONS THAT ARE SIGNED AND
DATED ARE CONSIDERED VALID. IF YOU HAVE ANY QUESTIOS REGARDING
THIS STATEMENT, PLEASE ASK THEM BEFORE SIGNING.
I certify that all answers and statements I have made on this application (and resumé or other
Supplementary materials) are true and complete without omissions. By signing below, I authorize
Polen Implement to investigate all statements contained in this employment application as they
deem necessary in arriving at an employment decision. I understand that nay false information
provided by me will likely result in a refusal to hire or immediate discharge if I am employed.
I authorize any of the persons or organizations named in this application to give you complete
information and records regarding my employment, education, character and qualifications.
If hired I will be responsible for familiarizing myself with all rules and regulations of
Polen Implement as they presently exist or are later modified. If hired, I understand my
Employment can be terminated, at the discretion of Polen Implement or at my option, without
notice, at any time and for any reason.
I understand this application is not an offer of employment and no promises or representations
of employment have been made to me at this time.
I have read, understand, and agree with the above.