This certifies that this application was completed by me, and that all entries on it are true and complete to the best of my knowledge. I recognize that any falsification, or misrepresentation (including omissions) made by me in connection with this application may disqualify me for further consideration for employment or, if discovered after I am hired, may be grounds for my immediate dismissal. I understand that all such information is subject to verification by the Company, and hereby give my consent to the Company to investigate my background and qualifications using any means, sources, and outside investigators at its disposal. I authorize my previous employer(s) to release any and all information relating to my employment with them. I further release and hold harmless both my previous employer(s) and Advanced Stimulation Technologies, Inc. from any and all liability that may potentially result from the release and/or use of such information. I agree to undergo any type of drug and/or alcohol testing that the Company may require at any time. I understand that any offer of employment is conditional as to the results of any job related pre-employment tests, examinations and investigation. Finally, I understand that submission of this application does not necessarily mean that I will be hired, and that if I am hired, my employment will be at will, and either I or the Company may terminate my employment at any time, with or without notice or reason.