APPLICANTS CERTIFICATION AND AGREEMENT
- Certification of Truthfulness.
I here by affirm that my answers to these statements and questions are true and correct to the best of my knowledge. I have not knowingly withheld any fact or circumstance that would, if disclosed, affect my application unfavorably. I certify that I have filled out this Application for Employment completely and that all statements are made truthfully and without evasion, and further I understand and agree that such statements may be investigated and if found to be false will be sufficient reason for not being employed, or if employed may result in my dismissal.
- Authorization for Employment/Educational Information.
I authorize the references listed in the Application for Employment, and any prior employer, educational institution, or any other persons or organizations to give this Company any and all information concerning my previous employment/educational accomplishments, disciplinary information, or any other pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you. I hereby waive written notice that employment information is being provided by any person or organization.
- Employment at Will.
If I am hired, in consideration of my employment, I agree to abide by the rules and policies of this Company, including any changes made from time to time,and agree that my employment and compensation can be terminated with or without cause, and with or without notice, at any time, at the option of either the Company or myself. I understand that no manager or other representative of the company, other than the owners, has any authority to enter into any agreement for employment for any specific or indefinite period of time, or to make any agreement contrary to the foregoing. I understand that any such agreement by the owners must be made in writing to be effective. I understand that this application is not a contract of employment.
- Authorization to Work.
If I am selected to hire I will be offered employment provided I verify that I am authorized to work as required by the Immigration Reform and Control Act of 1986.
- Limitations on Claims.
I agree that any action of suit against the Company arising out of my employment or termination of employment, including but not limited to claims arising under State or Federal civil rights statutes,must be brought within 180 days of the event giving rise to the claim or be forever barred. I waive any statute of limitations to the contrary.
- Need for Accommodations.
If I am a handicapped individual who requires an accommodation to perform the job, I must notify the Company of that need with 182 days after I knew or reasonably should have known that an accommodation was needed. Failure to do so will bar me from alleging that the Company has not accommodated me as required by law.
- Criminal/Driving Records Check.
I agree to execute an authorization for this employer to secure criminal conviction history and/or driving records from the appropriate law enforcement agency, should the Company determine it is necessary to do so.
- Release of Medical Information.
I authorize every medical doctor, physician or other healthcare provider to provide any and all information, including but not limited to, all medical reports, x-rays or clinical abstracts relating to my previous health history or employment in connection with any examination, consultation, test, or evaluation. I hereby release every medical doctor,healthcare personnel and every other person, firm, officer, corporation, association,organization or institution which shall comply with the authorization or request made in this respect from any and all liability. I understand that this release will not be sent to my physician or other health care provider until a job offer has been made.
- Physical Exam and Drug and Alcohol Testing.
I agree to take a physical exam and authorize the Company or its designated agent(s) to withdraw specimen(s) of my blood, urine or hair for chemical analysis. One purpose of this analysis is to determine or exclude the presence of alcohol, drugs or other substances. I understand that decisions concerning my employment will be made as a result of this test. The Company further reserves the right to engage in post employment Drug/Alcohol testing at its discretion.
- Credit Report.
I understand that the Company may request a consumer report or an investigative consumer report, including information as to my character, general reputation, personal characteristics and mode of living for general purposes of evaluating my application for employment. I further understand that I may request from the Company a complete and accurate disclosure of the nature and scope of the investigation requested. I consent to furnishing of such report to the Company.
- Consideration for Employment
I understand that my application will be considered pursuant to the Company’s normal procedures for a period of sixty (60) days and on file for a period of one year. If I am still interested in employment thereafter, I must reapply.
- Physical Capability.
To the best of my knowledge I am physically able to perform the functions of the job for which I am applying.