This institution does not
discriminate in hiring or any other decision on the basis of race,
color, gender, citizenship, national origin, veteran status, or on
the basis of age or physical or mental disability to perform the
work required. No questions on this application are intended
to secure information to be used for such discrimination.
I voluntarily give this institution the right
to make a thorough investigation of my past employment and activities, agree
to cooperate in such investigation and release all liability or
responsibility all persons, companies or corporate supplying such
information. I consent to the complete health screen, including
background screen and drug screen as may be required by this institution at
such times and places, as the institution shall designate. I
understand that a continued offer of employment may be contingent on passing
the health screen, including background screen and drug screen, which
relates to the essential duties I would be required to perform.
I acknowledge that if hired, I will be an at
will employee. I will be subject to dismissal or discipline without
notice or cause, at the discretion of the employer. I understand that
no representative of the company, other than the president, has authority to
change the terms of an at will employment and hat any such change can occur
only in a written employment contract. I also understand that my
employment may be terminated for any misstatement or omission of fact
appearing on this application form.
If employed, I will be required to complete
an Employment Verification Form (I-9), and within three days show
satisfactory evidence of identity and eligibility for employment.
this box to certify that you have read and accept the above statement.