Language
  • English (US)
  •  -
  •  -

  • Job Skills & Training

  • References

     Please list two (2) references that are familiar with your work life.

  • Reference 1

  •  -
  • Reference 2

  •  -
  • Agreement and Release

    For this agreement and release, the organization that has provided you with this application is referred to as “the company,” “this company,” or “you” in the following paragraphs: The facts set forth above in my application for employment are accurate and complete. I understand that false statements or omission of information on this application (even if discovered after employment) or any other employment form may lead to dismissal or denial of employment. You are now authorized to make any investigation of my personal history, financial, criminal, credit, public and news media records, academic/professional credentials, and motor vehicle records through any investigative or credit agencies or bureaus of your choice. You are also authorized to administer a personality profile or other pre-employment tests and verify my background. A criminal record or sentence is not an automatic disqualification for employment. I agree to submit to any drug or alcohol testing before or after employment, and I agree to submit to a medical evaluation if required. I consent to the release of any or all medical information or records deemed necessary to determine my capability to perform the essential job functions of the position for which I may hold. I understand and acknowledge that, should I be offered employment, the company and/or its agent may conduct periodic background checks of current employees as a condition of employment, and I authorize these periodic background checks. In making this application for employment, I also understand that an investigative consumer report may be made whereby information is obtained through personal interviews with my neighbors, friends, or others with whom I am acquainted. I also acknowledge that the company may search for information about me that is in the public domain, including, but not limited to, information on social networking sites. In exchange for the consideration of my employment application by this company, I hereby release and forever discharge this company (including its directors, officers, employees, and agents) and my past and/or present employers (including their directors, officers, employees, and agents) from any liabilities which may result from an investigation of my past and/or present employment or from the disclosure of such information. I authorize the use of any information in this application to verify my statements, and I authorize past employers, doctors, all references, and any other persons to answer all questions asked concerning my ability, character, reputation, and previous employment record. I understand that if my application is accepted and if I am hired, that employment with this company at all times is employment “at will.” It is further understood that this “at will” relationship may not be changed by any written document, verbal statements, or by conduct unless an authorized executive of this company specifically acknowledges such change. I further understand that my “at will” employment may be terminated at any time by this company or myself and includes no guarantee, contract, or promise of employment for any specific length of time. I understand that the first 90 days of employment is a new-hire introductory period. Submission of this application does not imply that you will be hired. I have read, understand, and by clicking "I agree" consent to these statements.*
  • Should be Empty:
Jotform Logo
Now create your own Jotform - It's free! Create your own Jotform