Job Application

List below last three employers, starting with the most recent one first.

Below, give the names of three persons you are not related to, whom you have known at least one year. Add your reference(s) below:

I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED IN THIS APPLICATION. IF EMPLOYED, I UNDERSTAND THAT MISREPRESENTATION OR OMISSION OF FACTS CALLED FOR IS CAUSE FOR DISMISSAL. I UNDERSTAND THAT IF I AM EXTENDED AN OFFER OF EMPLOYMENT IT MAY BE CONDITIONED UPON MY SUCCESSFULLY PASSING A COMPLETE PRE-EMPLOYMENT PHYSICAL EXAMINATION AND BACKGROUND CHECK. I CONSENT TO RELEASE OF ANY OR ALL MEDICAL INFORMATION AS MAY BE DEEMED NECESSARY TO JUDGE MY CAPABILITY TO DO WORK FOR WHICH I AM APPLYING. I RELEASE MY PREVIOUS EMPLOYERS, THE SCHOOLS I ATTENDED, AND THE PEOPLE I HAVE NAMED AS REFERENCES FROM ALL LIABILITY FOR ANY DAMAGES ARISING FROM THEIR RESPONSES TO THE COMPANY’S INVESTIGATION. I AGREE TO COMPLY WITH THE EMPLOYER’S SUBSTANCE ABUSE PROGRAM, INCLUDING DRUG AND/OR ALCOHOL TESTING AS MAY BE REQUIRED PRIOR TO EMPLOYMENT. IF EMPLOYED, I AGREE TO CONFORM TO THE RULES OF THIS COMPANY, AND HEREBY ACKNOWLEDGE THAT MY EMPLOYMENT WITH THE COMPANY CAN BE TERMINATED AT ANY TIME, WITH OR WITHOUT CAUSE, AT THE OPTION OF EITHER MYSELF OR THE COMPANY. I FURTHER UNDERSTAND AND ACKNOWLEDGE THAT NOTHING CONTAINED IN ANY EMPLOYEE HANDBOOK OR POLICY STATEMENT NULLIFIES OR MODIFIES THE FOREGOING EMPLOYMENT AT WILL POLICY.