Job Combined Application

JOB COMBINED APPLICATION

This application for employment is submitted by Applicant to Employer for the purpose of obtaining employment. The Applicant represents that all statements made herein are true and complete to the best of Applicant's knowledge. Applicant understands that any misrepresentation or omission may disqualify Applicant from further consideration and may be grounds for immediate termination if discovered after hire.

WHEREAS

WHEREAS Applicant seeks consideration for employment and has completed this Job Combined Application to provide personal, employment history, educational and authorization information; and

WHEREAS Employer may rely upon the information provided herein to evaluate Applicant's suitability for available positions and to perform such background, reference and credential checks as permitted by law.

POSITION AND AVAILABILITY

Full-time Part-time Temporary/Seasonal Internship

APPLICANT INFORMATION

Yes No

Yes No

EDUCATION

EMPLOYMENT HISTORY (MOST RECENT FIRST)

REFERENCES

SKILLS, CERTIFICATIONS, AND AVAILABILITY

BACKGROUND, AUTHORIZATIONS, AND CERTIFICATIONS

Have you ever been convicted of a felony or misdemeanor that has not been annulled, expunged or sealed by a court?

Yes No

Applicant certifies, acknowledges, and authorizes as follows: Applicant authorizes Employer to contact former employers, references, educational institutions, licensing authorities, and other persons or entities necessary to verify information contained in this application. Applicant authorizes those persons to provide truthful information and releases them and Employer from liability for information provided in good faith. Applicant understands that employment, if offered, may be conditioned upon satisfactory completion of background checks, drug screening, and verification of eligibility to work.

I consent to background checks, consumer reports, and verification inquiries as permitted by law.

CONFIDENTIALITY AND AT-WILL EMPLOYMENT

Applicant acknowledges that information obtained in the course of employment may be confidential and proprietary. Applicant agrees to comply with Employer's confidentiality and information security policies if employed. Nothing in this application shall be construed to create an express or implied contract of employment. If employed, Applicant's employment will be at-will, meaning either Applicant or Employer may terminate the employment relationship at any time, with or without cause or notice, unless otherwise agreed in a signed, written agreement.

GOVERNING LAW AND ENTIRE AGREEMENT

This application and any disputes arising out of Applicant's consideration for employment shall be governed by the laws of the state in which the position is located, without regard to conflict of law principles. This application contains the entire understanding between Applicant and Employer with respect to Applicant's submission for employment and supersedes all prior representations, statements, or agreements regarding such matters.

CERTIFICATION

By signing below, Applicant certifies under penalty of law that the information provided in this Job Combined Application is true, complete, and correct to the best of Applicant's knowledge. Applicant understands that falsification, misrepresentation or omission of facts may result in denial of employment or termination if discovered after hire.

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