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New Smyrna Beach/Edgewater

(386) 423-7551

 Flagler/Palm Coast

(386) 445-1887

East Volusia

(386) 756-1125

West Volusia

(386) 736-1190

Personal Information

Education

Former Employers

References

Authorization

"I certify that the facts contained in this application are true and complete to the best of my knowledge 
and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed 
above to give you any and all information concerning my previous employment and any pertinent 
information they may have, personal or otherwise and release the company from all liability for any 
damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any 
agreement for employment for any specified period of time, or to make any agreement contrary to the 
foregoing, unless it is in writing and signed by an authorized company representative."