Regional Office of Education #3 | Junior High Special Education

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I understand that if I am employed, any misrepresentation or material omission made by me on this application will be sufficient cause to warrant immediate discharge from employment whenever it is discovered.

I give Regional Office of Education #3 the right to contact and obtain information from all references, employers and educational institutions, and to otherwise verify the accuracy of the information contained in this application.

I hereby release Regional Office of Education #3 or representatives from any and all liability connected with seeking, gathering and using such information, as well as any and all other persons, corporations or organizations for furnishing such information.

I certify that I have read and fully understand the proceeding disclaimer.

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Junior High Special Education

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Employment History

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Education

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