* I have read and understand all of the provisions of this statement and acknowledgement. By signing this application, I hold DDS, LLC. harmless from any result of the reference check. I hereby authorize and release from liability all former employers, educational institution, law enforcement agencies, an non-governmental and governmental agencies to provide or release information regarding my employment, education, criminal conviction record, credit history, driver’s license and motor vehicle records that may be in their possession to the Company or its agents. I further understand that an offer of employment, and continued employment, is conditioned upon several criteria, including my satisfactorily passing certain laboratory test, including test for substance abuse, which may be required by the Company prior and during my employment.