Amalgamated Sugar Factory

I certify that the information in this application is correct to the best of my knowledge and I grant permission to American Staffing, Inc. to verify such information and to conduct such investigation as it deems necessary relevant to this application. Any false statement or misrepresentation on this application shall be sufficient cause for rejection of this application or for dismissal from employment. I also authorize previous employers to release American Staffing, Inc. such information as is relevant to my application for employment. I understand that any offer of employment may be subject to satisfactory completion of a medical examination including a drug screening test. In addition, during employment I may be subject to drug testing and failure to take or pass such a test will be grounds for termination. I further understand and agree that my employment with American Staffing, Inc. is at will and may be terminated by me or American Staffing, Inc. at any time and for any reason. I further understand and agree that the term of my employment with American Staffing, Inc. shall be limited to the duration of any temporary assignment hereunder. I certify that I am not applying for work with American Staffing, Inc. in order to secure regular employment, or further temporary employment, with an American Staffing, Inc. customer. I authorize American Staffing, Inc. to deduct any charges from my paycheck which may be incurred by me, such as uniforms, tools, drug tests, and background checks.