Release and Signature

Applicant Notes

This application form is intended for the use in evaluating your qualifications for employment. This is not an employment contract or guarantee of an interview. Please answer all appropriate questions completely and accurately. False or misleading statements during the interview and on this form are grounds for terminating the application process or, if discovered after employment, terminating employment. All qualified applicants will receive consideration without discrimination based on sex, marital status, race, color, age, creed, national origin, sexual orientation, military reserve membership, ancestry, religion, height, weight, use of a guide or support animal because of blindness, deafness or physical handicap, or the presence of disabilities. *A conviction, guilty or no contest plea will not necessarily bar an applicant from employment but will be judged on nature and age of charge, etc. Additional testing of job-related skills and for the presence of drugs in your body may be required prior and/or during employment.

Certification and Release

I certify that I have read and understand the applicant note on this form that the answers given by me to the foregoing questions and statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts called for in this application, whether on this document or not, may result in rejection of my application or discharge at any time during my employment. I authorize the company and/or its agents, including consumer reporting bureaus and appointed personnel of the Missouri Department of Social Services, Children's Division, to verify any of this information. I release the State of Missouri, all former employees, persons, educational institutions, partnerships, corporations, agencies, law enforcement authorities, and officers, agents, and employees of the aforementioned from any liability for any damage whatsoever for issuing this information. I also understand that the use of illegal drugs is prohibited during employment. If company policy requires, I am willing to submit to a drug test to detect the use of illegal drugs prior to and during employment. 

Release To Previous Employers

I, the undersigned, have applied for employment with Bridges Community Support Services and authorize previous employer(s) to verify employment data and to provide information concerning past performance under the provision of the Privacy Act of 1974. All information is kept confidential. I hereby authorize to issue any information you may have regarding my services and character and do hereby unconditionally release your organization from all liability for any damage whatsoever which might result from furnishing same. 

Your application will be kept for one year. Bridges Community Support Services is an at-will and equal opportunity employer. Bridges Community Support Services will make attempt at reasonable accommodation for employees of all abilities.