By submitting this form, you are stating that the information contained is correct to the best of your knowledge and understand that any omission or erroneous information is grounds for dismissal in accordance with the policy of Madrones. You authorize the references listed above to give us any and all information concerning your past employment and pertinent information they may have, personal or otherwise, and release all parties from the liability for any damage that may result from furnishing the same to us. If applicable to your employment, you have read and understood the notice regarding polygraph tests and your rights under Maryland law.