I certify that I have read and understood all of this employment application. It is agreed and understood that the employer or his agents may investigate my background to ascertain any and all information of concern to my employment history, whether same is of record or not, and I release employers and other persons named herein from all liability for any damages on account of furnishing such information. I understand that, as an applicant for a position with this company, I may be asked to demonstrate that I am capable of performing tasks which are pertinent to the job. I also understand that if offered a job, it may be conditioned on the results of a physical examination and drug test. I further certify that I am a genuine applicant for employment and this application is being submitted solely for the purpose of seeking employment with the employer and for no other reason.

I agree to furnish such additional information and complete such examinations as may be required to complete my employment file.

I also understand that misrepresentation or omission of information or facts may result in my rejection or dismissal. If hired, I agree to abide by all the rules and policies of the employer.

This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

I hereby consent to submit to urinalysis_ and/or other tests as shall be determined by Titan Transfer, Inc. in the selection process of applicants for employment, for the purpose of determining the drug content thereof.

I agree that Titan Transfer, Inc. may collect these -specimens for these tests and may forward them to a testing laboratory designated by the Company for analysis.

I further agree to and hereby authorize the release of the results of said tests to Titan Transfer, Inc.

I understand that it is the current illegal use of drugs and/or abuse of alcohol - . that prohibits me from being employed at this company.

I further agree to hold harmless Titan Transfer, Inc. and its agents from any liability arising in whole or part out of the collection of specimens, testing, .and use 9f the information said testing m connection with Titan Transfer's consideration of my employment application.

I have carefully read the foregoing and fully understand its contents. I acknowledge that my signing of this consent and release form is a voluntary act on my part and that I have not been -coerced into signing this document by anyone.