Industrial Pallet Corp. English

References

Three required
1st Reference *

First NameLast Name
Phone Number*
Occupation*
Years Known*
2nd Reference*

First NameLast Name
Phone Number*
Occupation*
Years Known*
3rd Reference*

First NameLast Name
Phone Number*
Occupation*
Years Known*

Upon receiving an offer of employment from Industrial Pallet, it will be a condition to the commencement of your employment that you pass a medical examination to test the presence of drugs or other controlled substances. All individuals entering employment must take and pass such an examination. Failure to pass the examination, or refusal to undergo any testing required as a part of the examination, will be justifiable cause for the Company to revoke its offer and to deny employment.
Are you willing to submit to a drug screen?*

YesNo
1. I authorize Industrial Pallet Corp., and its representatives to obtain/verify any information from any former employers (unless otherwise indicated), or from any personal references I provide as a part of this application. This includes any and all information concerning any personal and employment background references that the Company may deem relevant to the job position for which I have applied. I further release Industrial Pallet Corp, its agents and representatives, together with all parties furnishing information about me, from all liability as a result of obtaining, using or providing such information.

2. I understand that any false, misleading or incorrect statements made in this application, or given by me in the course of my application for employment, may be cause for termination of my employment, and that the Company shall not be liable in any respect if any employment is so denied or terminated because of a such false, misleading or incorrect statements, answers or omissions made by me.

3. I understand and agree that if I am employed by the Company, my employment is at will and not for a definite period of time and may be terminated at any time by me or the Company and that no company representative, other than it’s president, and then only when in writing and signed by the president, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the forgoing.

4. I hereby acknowledge, by my signature below, that I have read or have had read to me paragraphs 1, 2, and 3 above, and that I understand the meaning and intent of this information.
Signature*

Clear
Date*

MonthDayYear
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