Please specify schedule availability and clarify a.m. and/or p.m.
NOTE: In answering the following question, you should not answer “Yes” for any conviction that resulted in a referral to and participation in any pretrial or post-trial diversion program pursuant to California Labor Code section 432.7, any conviction specified in California Labor Code section 432.8 (which pertains to certain marijuana offences that are more than two years old), and any conviction that occurred when you were a minor that has been expunged or sealed by the court. A “Yes” response will not necessarily disqualify an applicant from employment. Failure to answer this question accurately could cause denial of employment or termination of employment if you are hired.
Please, list three persons we can contact about your technical skills and/or character (please do not include relatives)
1. I understand that the Company may obtain consumer reports, consumer credit reports and/or investigative consumer reports about
me, including a search of criminal records and verification of my education and employment history, in connection with this application
or during my employment if I am hired. I have authorized or will be authorizing the obtaining of such reports.
2. I hereby authorize all persons or businesses contacted by or on behalf of the Company about me to disclose to the Company any and
all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. I also authorize
the persons named here in as references to provide the Company with any pertinent information they may have about me. In addition, I
hereby fully release the Company, my former employers and all other persons, corporation, partnerships and associations from any and
all claims, demands or liabilities arising out of or in any way related to such information disclosures and background investigations.
3. I understand that as a condition of employment, and at any time during my employment, I may be required to take a physical
examination, which may include an alcohol and drug screening test, to determine my ability to perform my job in a manner that does not
endanger my own health or the safety and health of others.
4. I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the
Company and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application.
5. I understand and agree that nothing contained in this application or in the interview process will create a contract between the
Company and myself for either employment or for the providing of any benefits. If I am hired, I understand that I am free to resign at
any time, with or without cause or prior notice, and that the Company may terminate my employment at any time, with or without cause
or prior notice. This application does not constitute an agreement or contract for employment for any specified period or duration. I
understand that no supervisor or representative of the Company is authorized to make any promises different from those in this
paragraph and that no agreements contrary to the foregoing express at-will employment arrangement will be valid unless it is in writing
and signed by the Company’s CEO and me. This constitutes my entire agreement with the Company with regard to the nature of any
employment relationship I may have with the Company.
6. I understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and
that federal immigration laws require me to complete an 1-9 Form in this regard.
7. I HEREBY AKNOWLEDGE THAT I HAVE READ, UNDERSTAND AND AGREE TO THE FOREGOING PROVISIONS.
I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION (OR ANY RESUME OR OTHER DOCUMENTS
SUBMITTED) ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT ANY FALSE
INFORMATION OR OMISSIONS WILL DISQUALIFY ME FROM FURTHER CONSIDERATION FOR EMPLOYMENT, AND
WILL BE JUSTIFICATION FOR MY IMMEDIATE DISMISSAL FROM EMPLOYMENT IF DISCOVERED AFTER I AM HIRED.
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