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By pressing submit below, I certify that the above statements are true and complete. I understand that any false information or omissions (including, but not limited to, failure to reveal prior employers) in this application or its supporting documents, or in an interview, will be sufficient grounds for refusal to consider me for work, as an independent contractor and/or at-will employee catastrophe insurance adjuster and/or claims processor (non-catastrophe assignments) and/or office staff/examiner, and to terminate my relationship with CNC as an independent contractor or employee, if such is offered. I understand that completion of this application in no way constitutes an offer of employment or assignment as an independent contractor. I understand that this application form will be active for 30 days from the date of completion. If I wish to be considered to work with CNC after that time, I understand that I will be required to complete and submit a new application form. I authorize CNC to obtain information about me from my previous employers and to review my education, previous employment, driving records, criminal records, references, professional licenses and other background data. I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing same to you. I also acknowledge that a pre-employment or preassignment drug screening and further background screening may be required and agree to voluntarily consent to both, if such is required. I agree that a facsimile, electronic or photographic copy of this Application shall be valid as the original.