I hereby give you my permission to contact the above employers, references, and educational, licensing, credentialing, and certification institutions to verify the items I listed above. I hereby release The Lighthouse, Inc. and the above referenced organizations, reference persons and employers from all claims, liability and damages that may result from furnishing the information to you. I consent to releasing any information relating to my job performance which is documented in my personal file. In the event that a prior employer or other organizations is obligated to provide any written notice to me regarding the disclosure of information to The Lighthouse, Inc., I hereby waive that obligation and expect no written notice of disclosure of my personal information.
I understand that employees using their personal vehicle for business purpose must maintain auto insurance on their personal vehicle that is a minimum of the state requirement.
I also understand that because of the nature of my job and licensing requirements, I hereby consent to the release of this application or portions of this application to representatives of the Department of Human Services, Department of Community Health, local community mental health entities or other governmental agencies or private agencies, for all licensing or investigatory purposes and to verify information I have listed in this job application. I hereby release The Lighthouse, Inc., the Department of Human Services, Department of Community Mental Health, Local community mental health entities and other governmental agencies or private agencies from all claims, liability, and damages that may result form furnishing the information to you.
I further specifically waive written notice and agree to the divulging of any disciplinary reports, letters of all reprimand or other disciplinary actions by all prior employers, and hereby release prior employers from all claims, liability and damages that may result from furnishing the information to you.
In consideration of The Lighthouse's review of my application, I agree that any claim or lawsuit arising out of my employment with, or my application for employment with The Lighthouse Inc. or any of its subsidiaries must be filed no more than six (6) months after the date of the employment action that is the subject of the claim or lawsuit. While I understand that the statute of limitations for claims arising out of an employment action may be longer than six (6) months, I agree to be bound by the six (6) month period of limitations set forth herein, and I WAIVE ANY STATUTE OF LIMITATIONS TO THE CONTRARY. Should a court determine in some future lawsuit that this provision allows an unreasonably short period of time to commence a lawsuit, the court shall enforce this provision as far as possible and shall declare the lawsuit barred unless it was brought within the minimum reasonable time within which the suit should have been commenced.