I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT IF EMPLOYED, INCOMPLETE, FALSE OR MISLEADING STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL AT ANY TIME IN THE FUTURE.
I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN AND THE REFERENCES LISTED ABOVE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE, AND RELEASE ALL PARTIES FROM ALL LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM FURNISHING SAME TO YOU.
I ALSO AUTHORIZE YOU TO OBTAIN INFORMATION REGARDING MY RECORD FROM THE BUREAU OF MOTOR VEHICLES IF THE JOB FOR WHICH I AM APPLYING WILL REQUIRE DRIVING AS A PART OF MY JOB DUTIES.
I UNDERSTAND THAT PURSUANT TO THE COMPANY’S JOB APPLICATION PROCESS I MAY BE REQUIRED TO UNDERGO DRUG TESTING. I FURTHER UNDERSTAND THAT IF I REFUSE TO TAKE OR FAIL THE DRUG TEST, I AM DISQUALIFIED FROM FURTHER EMPLOYMENT CONSIDERATION. I HEREBY KNOWINGLY AND VOLUNTARILY CONSENT TO THE COMPANY’S REQUEST TO UNDERGO DRUG TESTING. I FURTHER RELEASE THE COMPANY AND ITS OFFICERS, AGENTS, REPRESENTATIVES AND EMPLOYEES FROM ANY AND ALL CLAIMS AND LIABILITY FOR DAMAGES ASSOCIATED WITH OR ARISING FROM MY SUBMISSION TO THESE TESTS.
IF HIRED, I AGREE TO CONFORM TO COMPANY RULES, REGULATIONS AND POLICIES. I UNDERSTAND THAT I WOULD BE AN EMPLOYEE-AT-WILL, AND AGREE THAT MY EMPLOYMENT AND COMPENSATION CAN BE TERMINATED WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE AT ANY TIME, FOR ANY REASON, AT THE OPTION OF EITHER THE COMPANY OR MYSELF. I UNDERSTAND THAT NO SUPERVISOR, MANAGER, OFFICER OR REPRESENTATIVE OF THE COMPANY OR ANY OTHER ENTITY OF THE COMPANY, HAS ANY AUTHORITY TO ENTER INTO ANY AGREEMENT FOR PROVIDING WORK FOR ANY SPECIFIED PERIOD OF TIME OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING OTHER THAN THE PRESIDENT AND THEN ONLY IN WRITING. I UNDERSTAND THAT NO PROMISE OF A BENEFIT IS BINDING UNLESS MADE IN WRITING AND SIGNED BY THE OWNER OF THE COMPANY.
I AGREE THAT ANY CLAIM I MAY HAVE RELATING TO MY APPLICATION TO, EMPLOYMENT WITH OR SEPARATION FROM THE COMPANY MUST BE FILED WITHIN SIX MONTHS OF INCIDENT GIVING RISE TO THE CLAIM.
