Emp. App. State Specific Disclosures

  • I understand and agree that, if hired, my employment will be at will, which means employment is for an indefinite period of time and may be terminated by myself or [EMPLOYER_NAME] at any time, with or without cause, and with or without notice.
  • I certify that all of the above information is true and complete and I understand that any falsification or omission of information made by me may disqualify me from further consideration for employment or, if hired, may result in my termination at any time during the period of my employment, regardless of the amount of time that has passed.

Note: An offer of employment is conditioned upon complying with [EMPLOYER_NAME]’s requirements including, but not limited to, signing a separate disclosure and consent form prior to any background check.

Emp. App. Get Initials

  • I understand that, where permissible under applicable federal, state, or local law, I may be subject to a pre-employment drug test after receiving a conditional offer of employment and must receive a negative result for illegal drug use before being permitted to commence work with [EMPLOYER_NAME].
  • I understand that, where permissible under applicable federal, state, or local law, I may be subject to a pre-employment medical examination after receiving a conditional offer of employment and must meet the qualifications for the position, with or without reasonable accommodation, before being permitted to commence work with [EMPLOYER_NAME].
  • I understand that, where permissible under applicable federal, state, or local law, I may be subject to a pre-employment background check after receiving a conditional offer of employment to investigate my criminal background [, driving record] [, credit history] and other matters related to my suitability for employment. I understand that a separate disclosure and consent form will be provided to me prior to any background check.
  • I understand that employment with [EMPLOYER_NAME] is also contingent on my providing sufficient documentation necessary to establish my identity and eligibility to work in the United States.
  • I authorize [EMPLOYER_NAME] and its representatives to contact my current and former employers (with the exception of my current employer, if I have marked “May we contact?” on page [3/PAGE NUMBER] of this application as “No”), schools, references, and other persons or organizations I have named in this application for the purpose of verifying the information I have provided. I release my current and former employers, schools, references, and other persons or organizations named in this application from any liability resulting from the information released. I authorize employers, schools, and other persons or organizations named in this application to provide any information or transcripts requested.
  • I hereby certify that, if employed, my employment with [EMPLOYER_NAME] will not conflict with, violate, breach, or result in default under, any contract, agreement, or understanding that I am a party to or am bound by, including any non-solicitation, non-competition, or other similar post-employment restriction or agreement I have with any current or former employer, other than the contracts, agreements, covenants, or understandings I have disclosed in this application, if any.

Emp. App. Intro

APPLICATION FOR EMPLOYMENT

Please provide complete and legible information. An incomplete application may affect your consideration for employment.

[EMPLOYER_NAME] is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee based on race, color, religion, creed, national origin or ancestry, sex, sexual orientation, gender identity, age, physical or mental disability, veteran or military status, genetic information, union membership, or any other legally recognized protected basis under federal, state, or local law. The information collected by this application is solely to determine suitability for employment, verify identity, and maintain employment statistics on applicants.

Applicants with disabilities may be entitled to reasonable accommodation under the Americans with Disabilities Act and certain state or local laws. A reasonable accommodation is a change in the way things are normally done which will ensure an equal employment opportunity without imposing undue hardship on [EMPLOYER_NAME]. Please inform the company’s personnel representative if you need assistance completing this application or to otherwise participate in the application process.

Emp. App. Employment Records Intro

List all employment experience for the past 5 years, starting with the most recent or present employer, including US military service or training. Using a separate section for each position, describe in detail all work experience. You may include as part of your employment history any verifiable work performed on a volunteer basis. Resumes may not be substituted in lieu of completing the following employment information.