(Proof of eligibility will be required before you can be employed)
For each level of schooling below, please write the school name, the city and state where it is
located, your major and minor subjects, and the degree or diploma you received.
(List below last employers, starting with the most recent one first)
List at least three responsible adults who have knowledge of your work ethic, experience, and ability.
(Do not include relatives)
(Conviction will not necessarily disqualify an applicant from employment)
If yes, email a copy of the agreement to email@example.com
Name the package(s).
JOB APPLICANT’S AGREEMENT AND CERTIFICATION
PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY BEFORE SIGNING
• In consideration of my employment, I agree to conform to the policies and procedures of the company. I understand that in accepting this application, the company is in no way obligated to provide me with employment and that I am not obligated to accept employment if offered. Furthermore, if employed, I understand that I am employed at will and that my employment and compensation can be terminated with or without reason, and with or without notice at any time.
• I understand that this application will be kept on file for one year from the date completed, after which time I would have to reapply in accordance with established company procedures.
• I also understand that any offer of employment is conditioned on pre-employment procedures, which includes a background check, tests and documentation. I will, upon request, sign all necessary consent and authorization and release forms. I voluntarily and knowingly authorize the company and/or its agents, to verify any aspect of the information contained in my employment application or through public and private sources. I authorize any third party organization to perform a consumer report and background investigation. I also authorize and consent any companies, schools or persons listed on this application (or accompanying resume) to give any information regarding my employment, qualifications and character to (Company). I understand that the employment information may include, but is not necessarily limited to, performance evaluation and reports, job descriptions, disciplinary reports, letters of reprimand, and opinions regarding my suitability for employment possessed by it.
• I voluntarily and knowingly, fully release and discharge, absolve, indemnify and hold harmless you, your agents and any former employer, person, firm, corporation, school or government agency, its officers, employees and agents from any and all claims, liability, demands, causes of action, damages, or costs, including attorney's fees, present or future, whether known or unknown, anticipated or unanticipated, arising from or incident to the disclosure or release of any such information to you, your agents, or consumer reporting agency.
• I understand that I may be required to take a drug test as a part of the application process, as a condition of employment or at any time during employment. I may also be required to take and pass a physical exam if I am selected for employment and before beginning employment.
• I agree that any claim or lawsuit relating to my service with (Company) must be filed no more than twelve (12) months after the date of the action that is the subject of the claim or lawsuit. I waive any statute of limitations to the contrary.
• I have read and understand the contents of this employment application and am fully able and competent to complete it.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER