I HEREBY CERTIFIY THAT THE INFORMATION IN THIS APPLICATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND I AUTHORIZE THE COMPANY TO CHECK THE INFORMATION PROVIDED. I AUTHORIZE THE REFERENCES LISTED ABOVE TO PROVIDE THE COMPANY WITH ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THAT THEY MAY HAVE. FURTHER, I RELEASE ALL PARTIES AND PERSONS FROM ANY AND ALL LIABILITY FOR DAMAGES THAT MAY RESULT FROM FURNISHING SUCH INFORMATION TO THE COMPANY, AS WELL AS FROM THE USE OR DISCLOSURE OF SUCH INFORMATION BY THE COMPANY OR ANY OF ITS AGENTS, EMPLOYEES, OR REPRESENTATIVES. I UNDERSTAND THAT ANY MISREPRESENTATION, FALSIFICATION, OR MATERIAL OMISSION OF INFORMATION ON THIS APPLICATION MAY RESULT IN MY FAILURE TO RECEIVE AN OFFER OR, IF I AM HIRED, IN MY DISMISSAL FROM EMPLOYMENT.
I AUTHORIZE THE COMPANY TO PROCURE A CREDIT REPORT OR INVESTIGATE A CONSUMER REPORT ON ME FOR EMPLOYMENT PURPOSES, SUCH AS HIRING, EVALUATING ME FOR PROMOTION, REASSIGNMENT OR RETENTION AS AN EMPLOYEE. I UNDERSTAND THAT AN INVESTIGATIVE CONSUMER REPORT MAY CONTAIN INFORMATION ABOUT MY CHARACTER, GENERAL REPUTATION, PERSONAL CHARACTERISTICS, AND MODE OF LIVING. I UNDERSTAND THAT I HAVE THE RIGHT TO MAKE A WRITTEN REQUEST, WITHIN A REASONABLE PERIOD OF TIME, FOR A COMPLETE AND ACCURATE DISCLOSURE OF INFORMATION REGARDING THE NATURE AND SCOPE, (NOT THE RESULTS), OF AN INVESTIGATIVE CONSUMER REPORT. I RELEASE ALL PARTIES FROM LIABILITY THAT MAY RESULT FROM THE COMPANY OBTAINING OR USING THIS REPORT.
IN CONSIDERATION OF MY EMPLOYMENT, I AGREE TO CONFORM TO ALL OF THE POLICIES, RULES AND STANDARDS OF THE COMPANY. I UNDERSTAND AND AGREE TO SUBMIT TO A DRUG SCREENING AS PART OF A CONDITIONAL OFFER OF EMPLOYMENT, AND ANY OTHER LAWFUL PRE-EMPLOYMENT SCREENING TEST. I ALSO UNDERSTAND THAT AN OFFER OF EMPLOYMENT BY THE COMPANY IS CONDITIONAL UPON SUCCESSFULLY PASSING A COMPANY-PROVIDED MEDICAL EXAMINATION AND DRUG SCREEN. I UNDERSTAND THAT MY REFUSAL TO TAKE THE MEDICAL EXAMINATION OR DRUG SCREEN WILL CAUSE THE CONTINGENT OFFER OF EMPLOYMENT TO BE WITHDRAWN, RESULTING IN TERMINATION IF EMPLOYED. I FURTHER AGREE TO SUBMIT TO DRUG TESTS REQUIRED UNDER THE COMPANY'S DRUG-FREE FEDERAL LAW. I ALSO AGREE TO TAKE MEDICAL EXAMINATIONS OR OTHER LAWFUL TESTS, ONCE I AM EMPLOYED BY THE COMPANY. I UNDERSTAND AND AGREE THAT MY REFUSAL TO SUBMIT TO SUCH TESTS OR A POSITIVE TEST RESULT MAY CAUSE MY NOT BEING CONSIDERED FOR EMPLOYMENT, OR IF ALREADY EMPLOYED, MY DISMISSAL.
I AGREE TO RECEIVE MY PAYCHECK BY DIRECT DEPOSIT AS A CONDITION OF MY EMPLOYMENT (WHERE PERMITTED BY LAW) AND WILL PROVIDE A BANK ACCOUNT AND SUCH OTHER INFORMATION AS IS NECESSARY TO EFFECT THE DIRECT DEPOSIT.
I UNDERSTAND AND AGREE THAT THIS APPLICATION DOES NOT CONSTITUTE AN EMPLOYMENT AGREEMENT AND MY EMPLOYMENT CAN BE TERMINATED AT WILL WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE AT ANY TIME, EITHER AT MY OPTION OR THE OPTION OF THE COMPANY. I UNDERSTAND THAT NO EMPLOYEE OR REPRESENTATIVE OF THE COMPANY HAS ANY AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT WITH ME FOR ANY SPECIFIED PERIOD OF TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING.
