Provide name and phone numbers of THREE of people under whose immediate supervision you worked.
Provide name and phone numbers of THREE personal references and indicate what your relationship is with them and how long you have known them.
I certify that all information I have provided in order to apply for and secure work with the employer is true, complete and correct. I understand that any information provided by me that is found to be false, incomplete, or misrepresented in any respect, will be sufficient cause to cancel further consideration of this application, or whenever discovered, to immediately to discharge me from the employer's service.