Give below the names of three persona not related to you, whom you have known at least 1 year.

This institution does not discriminate in hiring or any other decision on the basis of race, color, religion, sex, citizenship, national origin, sexual orientation, gender identity, ancestry, Vietnam era veteran status, or on the basis of age or physical or mental disability unrelated to ability to perform the work required. No question on this application is intended to secure information to be used for such discrimination. I certify that my answers are true and complete to the best of my knowledge. I voluntarily give this institution the right to make a thorough investigation of my past employment and activities, agree to cooperate in such investigation and release from all liability or responsibility all persons, companies or corporations supplying such information. I consent to take the physical examination and drug screen and such future physical examinations as may be required by this institution at such times and places as the institution shall designate. I understand that an offer of employment may be contingent on passing the physician examination which relates to the essential duties I would be required to perform. I understand that my employment is at will and that either party is free to terminate the employment relationship at any time without cause. I understand that my employment may be terminated for any misstatement or omission of fact appearing on this application form