Date of Birth: *
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By checking "I accept", I understand and agree that the information I have provided above and will provide in subsequent questions is true. I understand that falsifying such information will lead to my immediate disqualification as an employee of Avery Health Staffing and that such falsification may lead to both civil and criminal penalties under state and Federal law. I understand that the information I have provided to Avery Health Staffing will be used solely for the purposes of my employment. I understand and agree that Avery Health Staffing and / or its agents may use this information to verify my employment history, credit history, criminal and legal histories.
