The information provided on this application is accurate to the best of my knowledge and subject to verification by this company. I understand I must truthfully answer all the questions on this application. I also understand that if I do not, I may be refused employment or be terminated immediately. I will agree to Newbridge Place conducting both a background check and driving record. I have not been convicted of or pleaded guilty to a disqualifying offense as listed or described in divisions (A) (3) (a) to (A) (3) (e) of section 109.572 of the revised code. I agree to notify the residential facility within fourteen calendar days if, while employed by the residential facility, I have been formally charged with, is convicted of, or pleaded guilty to a disqualifying offense. Failure to make the notification may result in termination of my employment.