PERMISSION TO CONDUCT BACKGROUND INVESTIGATION
The information requested below is for the sole purpose of conducting a background investigation which includes, among other things, a criminal conviction check. The existence of a prior criminal conviction will not necessarily make you ineligible for employment, it is IPPC Pharmacy’s Policy to evaluate any adverse information obtained in the background investigation based on a range of factors including, but not limited to, employment history and time, nature and job-relatedness of the offense. This form along with the final report will be placed in a separate file and will not be part of your personnel file should you be hired.
This information will be used for purposes of identification and pre-employment only and will not be used for discriminatory purposes. General Law prohibits discrimination in employment on the basis of age, race, color, creed, religion, sexual orientation, disability, or national origin. Many states also prohibit some or all the above types of discrimination and may also include marital status or other categories.
I acknowledge that consideration for employment is contingent on the results of a reference check, credit check, criminal record check, background check, negative drug screen result, my ability to establish employment eligibility under the Immigration Reform and control act of 1986 and upon verification of the information provided by me in my application, my resume or in other parts of the application process.
I understand that in making this application for employment, IPPC PHARMACY or any agent acting on its behalf may request an investigative consumer report, or other such information obtained through personal interviews with third parties such as neighbors, friends, business associates, financial sources and acquaintances. I authorize IPPC PHARMACY, its affiliates and representatives to verify all information provided by me in the application process and to inquire into my character, general reputation, personal characteristics and mode of living. I expressly authorize all employers, personnel, schools, companies, corporations, and law enforcement agencies to supply any and all information concerning my qualifications for employment and to verify the information given by me herein or elsewhere in the application process. In consideration for being a candidate for employment, I release IPPC PHARMACY, related entities, as well as any individual or entity providing information from any and all liability in connection with inquiries and investigations, information given, decisions made, or action taken concerning my employment based on such information.
I understand that employee screening or other tests, including drug screening, may be a condition of employment and refusal to take such tests when asked will subject me to termination. I also understand that no person is authorized to enter into written employment contracts on behalf of IPPC PHARMACY. I hereby acknowledge that no verbal promises or contracts are authorized by IPPC PHARMACY and upon my acceptance of employment; I expressly acknowledge that no such verbal promise, inducements, or verbal contracts have been made.
I hereby authorize IPPC PHARMACY or its agents to investigate my background to determine all information of concern to my record, whether same is of record or not, and I release employers and persons named in my application from all liability for any damages on account of his/her furnishing said information.
Additionally, you are hereby authorized to make any investigation of my personal history, educational background, military record and criminal records through an investigative or credit agency or bureau of your choice. I authorize the release of this information by the appropriate agencies to the investigating service.