I understand that any false statements or material omissions made as a part of this application will disqualify me from
further consideration for employment and, if discovered later, will be grounds for discharge. I also understand that any
offer of employment is contingent upon the results of a pre-employment medical examination, drug screen, criminal
background check and reference check. I authorize my former employers to release all information concerning my
employment. I further authorize the release of any such information during or after my employment, without prior
notification. This authorization releases the aforesaid parties and Direct Home Health Care Inc. from
any liability for the collection and reporting of this information. Direct Home Health Care Inc. does not
discriminate in hiring or employment on the basis of sex, color, marital status, religion,sexual orientation, national origin,
age, disability, military status, or any other protected category. No question on this application is intended to secure
information to be used for such discrimination. I understand that if I am employed by Direct Home Health Care Inc., my employment is “at will”
and may be terminated by me or by Direct Home Health Care Inc. at any time with or without cause, for any reason. No one other than the
President of Direct Home Health Care Inc. has the authority to enter into an agreement contrary to the foregoing and any such agreement
must be in writing and signed by both the President and me.