Employment Application Kit

Employment Application Kit

Personal Information

Are you legally authorized to work in this country?   Yes No

Are you 18 years of age or older?   Yes No

Position Desired

Employment type desired:   Full-Time Part-Time Temporary

Employment History (Most Recent First)

Education

Professional References

Legal Disclosures & Authorizations

At-Will Employment: I understand and agree that if employed, my employment will be at-will. This means that either the employer or I may terminate the employment relationship at any time, with or without cause or notice, except as may be required by applicable law, and that no representative of the employer has authority to enter into any agreement to the contrary unless in writing signed by an authorized representative of the employer.

Equal Opportunity: The employer is an equal opportunity employer. Decisions regarding hiring, promotion, compensation, and other terms and conditions of employment are made without regard to race, color, religion, sex, national origin, age (where protected), disability (where protected), genetic information, or other status protected by applicable law.

Background Checks and Reference Contacts: I authorize the employer to investigate my background, including, but not limited to, employment history, education, criminal record, motor vehicle records, and other job-related information. I expressly authorize all former employers, references, educational institutions, and organizations to release information concerning my employment, education, and other pertinent matters. I release the employer and all persons and entities providing information from any liability arising out of such inquiries and disclosures.

Drug Testing and Medical Examinations: I understand that the employer may require drug screening and job-related medical examinations as a condition of hire or continued employment where permitted by law. Any offer of employment may be conditioned on successful completion of required tests and examinations.

Conviction Disclosure: Have you ever been convicted of a felony? Yes No

Applicant Certification and Authorization

I certify that the information provided in this application and any attachments is true, complete, and correct to the best of my knowledge. I understand that false statements or omissions may disqualify me from further consideration for employment or result in dismissal if discovered after hire. I authorize the employer to verify any information provided and to obtain any necessary records to evaluate my qualifications for employment.

I understand that submission of this application does not constitute an offer of employment or create a contract of employment unless a written offer signed by an authorized representative of the employer is provided. I further understand that any employment offer may be conditioned upon satisfactory results of reference checks, background checks, drug testing, and other pre-employment requirements as permitted by law.

Authorization to Contact: By signing below I authorize the employer to contact the references and previous employers listed in this application. I waive any right to inspect references provided on my behalf.

Acknowledgment

By signing below, I acknowledge that I have read, understand, and agree to the statements above. I certify under penalty of perjury that the information contained in this application is true and correct.

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