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Address
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Education
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References
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Previous Employment
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Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. If hired, I agree to conform to the rules, regulations and policies of Belvedere Pharmacy, LLC. I understand that my employment can be terminated with or without cause and with or without notice, at anytime, at the option of either the company or myself.

I agree that any claim or lawsuit relating to my employment with Belvedere Pharmacy, LLC must be filed no more than six (6) months after the date of the employment action that is the subject of the claim or lawsuit. I waive any statute of limitations to the contrary.
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