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Certified Occupational Therapy Assistant
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I authorize this Agency to contact previous employers. If hired, I agree to complete a health assessment for the position. I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.

In the event of employment, I understand that false or misleading information given in my application or interview(s) shall be sufficient cause for immediate dismissal. I understand also, that I am required to abide by all rules and regulations of Constructive Partnerships Unlimited .

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