Authorization
Please read the following paragraphs and sign and date below verifying you have read and understand
paragraphs. If your signature and date is not below, your application will be considered incomplete and you may not
be considered for employment.
"I certify that the facts contained in this application are true and complete to the best of my knowledge and
understand that, if employed, falsified statements on this application shall be grounds for dismissal.
I authorize investigation of all statements contained herein and the references and employers 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 the company from all liability for any damage that may result from utilization
of such information.
I also understand and agree that no representative of the company has any authority to enter into any agreement
for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is
in writing and signed by an authorized company representative.
This waiver does not permit the release or use of disability-related or medical information in a manner
prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws.
I understand that a consumer credit report or criminal records check may be necessary prior to my employment.
If such reports are required, I understand that, in compliance with federal law, the company will provide me
with a written notice regarding the use of these reports and will also obtain a separate written authorization
from me to consent to these reports. I also understand that a poor credit history or conviction will not
automatically result in disqualification from employment."
In compliance with federal law, all persons hired will be required to verify identity and eligibility to work
in the United States and to complete the required employment eligibility verification document form upon hire.
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