Persons not related to you who are familiar with your experience, training, and character.

Examples: employers, supervisors, teachers or co-workers.

Disclaimer:

I understand that if I am employed, any misrepresentation or material omission made by me on this application will be sufficient cause to warrant immediate discharge from employment whenever it is discovered. I give Pinckneyville Community Hospital the right to contact and obtain information from all references, employers and educational institutions, and to otherwise verify the accuracy of the information contained in this application. I hereby release Pinckneyville Community Hospital or representatives from any and all liability connected with seeking, gathering, and using such information, as well as any and all other persons, corporations, or organizations for furnishing such information.