A. I certify that the information contained in this application is correct and complete. I understand that anyfalse or misleading statements or omissions made in this application or interview(s), whenever discovered,are grounds for disqualification from further consideration or for dismissal from employment, regardless ofhow discovered.
B. If employed by Holdsambeck Behavioral Health, I AGREE TO CONFORM TO THE COMPANY’SGUIDELINES AND POLICIES AND UNDERSTAND THAT MY EMPLOYMENT IS AT-WILLAND CAN BE TERMINATED AT ANY TIME AND FOR ANY REASON BY THE COMPANY ORBY ME WITH OR WITHOUT ADVANCE NOTICE.
C. I understand and agree that only the President of Holdsambeck Behavioral Health has any authority to enterinto any agreement to employ me for any specified period time or to modify terms and conditions ofemployment. I agree that such an agreement must be in writing and signed by the President, and will notrely upon any other representations regardless of the source.
D. I understand and agree that Holdsambeck Behavioral Health may make a full and complete investigation ofmy personal or employment history, and authorize any former employer, person, firm, corporation, school,government agency, or other entity to provide Holdsambeck Behavioral Health with any information(including fact or opinion) they may have regarding me. In consideration of Holdsambeck BehavioralHealth review of this application, I release Holdsambeck Behavioral Health and all providers of anyinformation from any liability which may arise as a result of furnishing and receiving this information. Iunderstand and agree any employment offer or continued employment shall be conditional on the receipt ofsatisfactory references as determined by Holdsambeck Behavioral Health. If employed by HoldsambeckBehavioral Health, I further authorize the company to provide truthful information (including fact oropinion) regarding my employment to any potential or future employer and release and waive any claimsagainst Holdsambeck Behavioral Health for truthfully communicating any such information to a potentialor future employer.
E. I understand and agree that I may be required to submit to drug testing and a complete post-offer medicalexamination as part of my application for employment. I understand and agree that I may be required tosubmit to a complete medical examination during my employment with Holdsambeck Behavioral Health,provided that such examination is job-related and consistent with business necessity. I authorize thephysician conducting the examination and any laboratory testing any specimen obtained by the physician orcollection site to disclose the results of the examination and the laboratory test to Holdsambeck BehavioralHealth in accordance with state and/or federal laws. Holdsambeck Behavioral Health will keep such resultsconfidential and disclose the results only to persons who need to know or where required by law. I alsoagree to fully cooperate and provide Holdsambeck Behavioral Health with any additional consent(s) and/orrelease(s) as required by Holdsambeck Behavioral Health to investigate my employment application.
F. I understand and agree that if offered employment by Holdsambeck Behavioral Health, I may be requiredto disclose criminal conviction information in accordance with the law, and that any such employment offershall be conditional upon receipt of a satisfactory criminal conviction record as determined byHoldsambeck Behavioral Health.
G. I understand and agree that if offered employment by Holdsambeck Behavioral Health, I may be requiredto disclose military service information in accordance with law, and that any such employment offer shallbe dependent upon the receipt of a satisfactory military record as determined by Holdsambeck BehavioralHealth.
H. If hired, I agree not to disclose or use confidential information belonging to prior employers and that I willinform Holdsambeck Behavioral Health of any agreements that would limit my ability to work forHoldsambeck Behavioral Health.
I. I understand and agree that all of the foregoing terms and conditions will become part of my employmentrelationship with Holdsambeck Behavioral Health if I am employed the company.