Application for Union Rescue Squad

Please answer the following questions

1. It is the policy of Union Rescue Squad, Inc to provide equal opportunity in employment. Applicants are considered for all positions, and employees are treated during their employment without regard to their race. color, religion, sex, national origin, age, marital status, sexual orientation, military or veteran status, or any on-job related disability or medical condition. 2. Union Rescue Squad, Inc. is an "at will" employer which means that employment is for no fixed period of time and may be terminated by me or Union Rescue Squad, Inc. at any time with or without cause, and with or without advance notice. 3. Employment is contingent upon verification of past employment, education, references, and my ability to verify eligibility for employment in the United States. 4. I hereby authorize Union Rescue Squad, Inc. to request from each of my employers and other persons listed as references on thisapplication my full employment records. 5. I understand that any false or misleading information given in this application or interview(s) may be reason for rejection of this application, job offer, or considered grounds for dismissal. 6.I understand that if I am offered employment that I am required to abide by all rules and regulations of Union Rescue Squad Inc. 7.It is the policy of Union Rescue Squad, Inc. to maintain a drug-free workplace. Depending upon location of prospective employment, offers of employment may be contingent upon satisfactory results of a drug screening test. Applicants who are subject to a drug screening test will be required to sign a Consent Form authorizing Union Rescue Squad, Inc. to have its designated clinic, hospital or laboratory perform the drug screening test. Applicants who refuse to sign the Consent Form or whose test results are positive will not be considered for employment. 8. Depending upon the location and/or position, you may be subject to a background investigation or required to obtain a security clearance. Employment is contingent upon successful completion of the background investigation or your ability to obtain and maintain a security clearance.

I certify that I have given true. accurate and complete information on this form to the best of my knowledge. In the event confirmation is needed in connection with my work, I authorize educational institutions, associations, registration and licensing boards, and others to furnish whatever detail is available concerning my qualifications. I authorize investigation of all statements made in this application and understand that false information or documentation, or a failure tp-disclose relevant information may be grounds for rejection of my application, disciplinary action or dismissal if I am employed, and (or) criminal- action. I further understand that dismissal upon employment shall be mandatory if fraudulent disclosures are given to meet position quaifications (Auth G.S. 126-30, G.S. 14-122.1.)