BY TYPING MY NAME IN THE BOX BELOW, I certify that all information provided on this application is true and complete to the best of my knowledge. I understand that falsification, misrepresentation or omission of facts called for in this application may result in the denial of employment or immediate dismissal. I understand that if I am employed by Hearthway, Inc, that my employment is for no definite term (at-will) and that I can be terminated at any time with or without notice and with or without cause. I further understand that no verbal promises or guarantees are binding with Hearthway, Inc. If employed, I agree to abide by all of Hearthway’s rules and policies and any changes thereto. I understand that a job offer may be contingent upon the satisfactory results of a Criminal Background Check (CORI), Sexual Offender Registry, and reference check. I give Hearthway, Inc. permission to investigate all pertinent information concerning my application to determine my qualifications for employment. I understand that any offer of employment may be rescinded if the results of the investigation do not align with the mission and values of the organization. Massachusetts General Laws c.149 s19B requires that the following statement be included on employment applications: “It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.”

BY TYPING MY NAME IN THE BOX BELOW, I give Hearthway permission to contact my references should a contingent offer of employment is considered.