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Certification

I certify that answers given herein are true and complete to the best of my knowledge.  I authorize you to make such investigations and inquiries of my personal, employment, and financial history as well as inquiries about my character, honesty, habits, ability, driving record, and records of criminal convictions, if any.  I further understand that any false statements, misrepresentations made by me or material omissions made by me on this application will be sufficient grounds for immediate discharge.

I authorize Las Vegas Harley-Davidson (hereinafter referred to as "Company") to conduct a drug screening test through its designated physician, medical facility or laboratory testing facility as a condition of employment.

In applying for employment, I understand that a drug screening test will be administered as part of the pre-employment process to determine the presence of certain drugs and substances prohibited by Company Policy, such as illegal drugs, controlled substances, marijuana, mood or mind-altering substances, "lookalike" substances, designed and synthetic drugs, certain inhalants and unauthorized prescription drugs.  I further understand that the presence of any of the drugs or substances will cause my rejection from further consideration for employment, and that I may not reapply for any position at Las Vegas Harley-Davidson for a period of not less than six (6) months.

I agree that test results provided by the Company-approved physicians or testing laboratories shall be conclusive and final, and that test results provided by physicians or testing laboratories not approved by the Company will not be accepted or considered valid.

I understand that refusal to submit to the drug screening test will constitute voluntary withdrawal of my application for employment.

I fully understand that should I be conditionally put to work by the Company prior to the results of the drug screening test being known, my continued employment with the Company is conditional upon passing the drug screening test.  If I should test positive on the drug screen, indicating the presence of a prohibited drug or substance, I further understand I will be terminated immediately.

I authorize the results of this drug screen test to be given to the Company.

I release and hold the Company designated physician, testing laboratory and medical facility harmless for release of this information.  I also release and hold harmless the Company, its directors, officers, stockholders and employees for the use of this information for employment purposes.

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