Employee eSign Application

EMPLOYEE ESIGN APPLICATION

Personal Information

Position Information

Employment Type: Full-time Part-time Temporary Contract

Employment History (Most Recent First)

Education

Professional References

Legal Disclosures and Acknowledgements

At-Will Employment: I understand that submission of this application does not create a contract of employment. If hired, I acknowledge that employment with the Company is at-will and may be terminated by either party at any time, with or without cause or notice, unless a written agreement signed by an authorized company representative provides otherwise.

Equal Opportunity: The Company provides equal opportunity for all applicants and employees without regard to race, color, religion, sex, national origin, age, disability, genetic information, veteran status, or any other protected characteristic under applicable law.

Background and Reference Checks: By submitting this application I authorize the Company and its agents to verify all information contained herein, to obtain criminal, credit or other consumer reports where permitted by law, and to contact past employers and listed references to inquire about my employment history, job performance, and suitability for employment.

Applicant certifies that all statements and answers on this application are true, complete and made in good faith. I understand that false or misleading statements or the omission of information may result in denial of employment or termination if employed.

I acknowledge the At-Will Employment statement above.

I acknowledge the Equal Opportunity statement above.

I authorize background checks and contact with prior employers and references as described above.

Electronic Signature (eSign) Consent

Consent to Electronic Records and Signatures: I consent to receive and sign documents electronically in connection with my application and any subsequent employment relationship. I agree that electronic signatures, initials, and other electronic consents have the same legal effect as handwritten signatures and may be relied upon by the Company. I understand I may withdraw consent by providing written notice, but such withdrawal will not affect transactions completed prior to withdrawal.

Hardware and Software Requirements: To access and retain electronic records and to sign electronically, I will use devices capable of receiving and displaying electronic documents. I understand that I am responsible for maintaining the means to access those electronic documents.

I consent to electronic delivery of notices, policies, payroll documents and personnel records and agree to use electronic signatures where applicable.

Preferred eSign Email (if different from above):

Criminal History

Have you ever been convicted of a crime that has not been annulled, expunged, or sealed? No Yes

If yes, provide details:

Applicant Certification

By signing below, I certify under penalty of perjury that the information provided in this application and any attachments is true, correct and complete to the best of my knowledge. I authorize the Company to investigate all statements contained herein, to verify education and employment history, and to obtain additional information as permitted by law. I understand that any falsification, misrepresentation, or omission may result in refusal to hire or, if hired, termination.

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