I certify that the answers given by me in this application are true and correct without omissions of any
kind. I understand that any misleading or incorrect statements may render this application void. If I am
employed and it is subsequently discovered that any answer given by me is incomplete, misleading or
incorrect, I may be terminated. I agree that Marshfield Utilities shall not be held liable in any respect
if my employment is terminated because of false, incomplete or misleading statements, answers or
omissions made by me in this application.
I also authorize pertinent companies, schools, agencies, municipalities or persons to give to Marshfield
Utilities any information requested regarding my employment, character, experience and qualifications
and/or suitability for employment with Marshfield Utilities including a check of my fingerprints and
police record for the purpose of considering my suitability for hire. I hereby forever release, discharge
and covenant not to sue any person or organization for any result of providing, obtaining or acting upon
such information. I understand that such information is sought with confidentiality and will not be
released to me in any form whatsoever.
In addition, a copy of this authorization is as valid as the original and should be recognized as such.
I further understand that I may be asked to undergo a physical examination, including substance abuse
screening, prior to an appointment to a position with Marshfield Utilities. Refusal to participate will
result in the rejection of my application.