Applicant Statement Please read the following statements carefully before signing this application. Only those applications that are signed, dated and completed in full are considered valid.

I certify that all information I have provided is true, complete and correct. I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to cancel further consideration of this application, or immediately discharge me from the employer?s service, whenever it is discovered.

I expressly authorize, without reservation, the employer/CDS vendor, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application.

I hereby waive any and all rights and claims I may have regarding the employer/CDS vendor, its agents, employees or representatives for seeking, gathering and using such information in the employment process and all other persons, corporations or organizations for furnishing such information.

I understand that the employer/CDS vendor does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law. Advantage In-Home Services, LLC and Advantage Consumer Directed Services, LLC are Equal Opportunity Employer/Vendors and Drug Free Workplaces.

I understand that this application remains current for only 60 days. At the conclusion of that, if I have not heard from the employer/CDS vendor and still wish to be considered for employment, it will be necessary to reapply and fill out a new application.

This application does not constitute an agreement or contract for employment. I understand that this employer is required to run various state and federal background checks and my potential employment is contingent on the results. I also may be required to pass a drug test prior to or during employment.

I also understand that if I am hired, this Company/CDS vendor participates in E-Verify and I will be required to provide photo proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

I acknowledge that if I am applying to be an attendant through the CDS program, I understand that Advantage Consumer Directed Services, LLC is NOT my employer but acts as a third party vendor and is acting on behalf of the CDS Consumer. The CDS Consumer makes the decision on who to offer employment to.

I have read and understand the foregoing statements and accept the same as conditions of my employment.

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