I attest that I am the applicant and the information provided in this application is complete and accurate, to the best of my knowledge. Providing incomplete or inaccurate information may result in disqualification from the program, and may be a violation of state law(s) that could result in civil penalties. The Company may also share information regarding applicant's employment with its affiliates and appropriate governmental or licensing entities; and send me employment opportunity-related information at fax numbers or email addresses that I provide. The Company does not control the information provided by other users that is made available through the system. Although US NurseLink makes its best efforts t verify the information provided by other users, please use caution and common sense when using the venue. ALL OTHER ARRANGEMENTS shall be specified in the individual staffing agreements and/or rate schedule/service agreement.