Employee Staff Forms

EMPLOYEE STAFF FORMS

Personal Information

Date of Birth:    Social Security Number:

Emergency Contact

Position Information

Intended Start Date:    Salary / Rate: $

Full-time    Part-time    Temporary    Contractor

Employment History — Most Recent Employer

Previous Employer

Education

Major / Field:    Graduation Date:

References (Professional)

Legal Disclosures & Authorizations

At-Will Employment: I understand that if hired, my employment will be at-will and either I or the employer may terminate the employment relationship at any time, with or without cause or notice, except as expressly provided in a separate written agreement signed by an authorized representative of the employer.

Equal Employment Opportunity: The employer provides equal employment opportunity to all applicants and employees without regard to race, color, religion, sex, national origin, age, disability, genetic information, or any other characteristic protected by applicable law. This policy applies to all employment practices, including recruitment, hiring, promotion, discipline, and termination.

Background Checks and Verification: I authorize the employer and its agents to investigate my background, including but not limited to credit where job-related, criminal history, driving record, education, employment history, and professional licenses. I authorize former employers, educational institutions, and references to provide information requested. I waive any right to bring a claim against any provider of such information for furnishing that information.

Consent to Drug Screening: I understand and agree that, as a condition of hire and continued employment, I may be required to submit to drug and alcohol testing in accordance with employer policy and applicable law. I consent to such testing and to disclosure of results to the employer.

Confidentiality and Return of Property: I agree to preserve the confidentiality of proprietary, customer, personnel, and financial information. I will return all employer property upon termination and acknowledge that unauthorized retention or disclosure of confidential information may subject me to disciplinary action, including termination and legal remedies.

Authorization to Work: I certify under penalty of perjury that I am legally authorized to work in the country where the position is located and that I will provide documentation of identity and employment authorization as required by law.

Consent for Background Check: I consent to the background checks described above.

Consent for Drug Testing: I consent to drug and alcohol testing as required.

Applicant Certification

I certify that all information provided on this form is true, complete, and correct to the best of my knowledge. I understand that any false statements or omissions may result in rejection of my application or, if hired, disciplinary action up to and including termination. I authorize the employer to rely on this certification in making employment decisions.

Authorization to Contact Previous Employers and References: I hereby authorize the employer and its agents to contact the employers and references listed on this form and to obtain any relevant information concerning my previous employment and qualifications. I release the employer and all such sources from any liability for damages arising from providing or using such information.

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