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Declaration

1. I hereby authorize Upson Electric Membership Corporation, to whom this application is submitted to contact school, college, employment, and all other sources for the purpose of investigating and verifying statements and references herein and I authorize the above sources to provide such information and release them from all liability in connection with providing to Upson Electric Membership Corporation job-related information concerning my education or employment.
2. I understand that my application will be investigated. I warrant the foregoing to be a truthful and complete statement of fact. Furthermore, any untrue or misleading answer or concealment of any fact will constitute grounds for no further consideration of my application or immediate discharge at any time during my employment that such false statements become known.
3. I submit this application with the understanding that a drug screen is a condition to employment. I also understand that failure to consent to a screen for drugs will be considered a withdrawal of my employment application and that a negative drug screen is a requirement of employment. I authorize the drug testing facility to release the results of this drug screen to the authorized representative of Upson EMC.
4. I agree that if I am employed by Upson EMC, during and after such employment, I will not disclose or otherwise use any proprietary or confidential information that comes into my possession during the course of such employment, whether with respect to products, customers, suppliers, or otherwise.
5. I understand that my employment and compensation, regardless of the time or method of payment, can be terminated, with or without cause, at any time, at the option of either the company or me. I further understand that no personnel recruiter, interviewer, or representative of the company, other than the president or designated representative, has any authority to enter into any agreement for employment for any specified period of time or any agreement contrary to the foregoing, and if such agreement is made, it must be in writing.

It is our company's policy to perform employment background checks in connection with employment applications. In performing the background checks we may request a "consumer report" to learn information about you that may be used in making an employment decision. A "consumer report" is a report obtained from a consumer reporting agency (such as, but not limited to, Merchants Credit Bureau, Equifax, Experian, TransUnion, or the agency who will obtain the information for us) that has a bearing on your credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living. The report may include but is not limited to your credit report; educational information; criminal record; and motor vehicle driver's license or driving record. If Upson EMC requests an investigative consumer report, which would include personal interviews, you will receive a second notice indicating that the report has been requested no later than three days after the request is made to a consumer reporting agency. This additional notice, if issued, will advise you as to your further rights pertaining to investigative consumer reports. If any adverse action that is made with regard to your application or employment based entirely or in part on the information contained in a consumer report, you will be notified as to the basis of that decision and given a copy of the report as well as a summary of your applicable rights. If you have ever filed for bankruptcy, such information may or may not be relevant for employment purposes, but no employment decision will be based solely on this information. Your signature on our employment application or any other pre-employment forms authorizes us to obtain such a consumer report. Your signature indicates that you have carefully read and understand this notice and consent to the release of a consumer report or investigative consumer report to Upson EMC for employment purposes at Upson EMC's discretion either in connection with your job application or in connection with any future decisions concerning your employment, promotion, reassignment, or retention as an employee. Your signature reflects your understanding that such consent will remain in effect indefinitely until you revoke it in writing. You will not be considered for employment if you do not allow us to perform an employment background check.