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I certify that the statements I have made are true and correct and without
material omission. I understand that making false statements or omitting
pertinent facts is sufficient cause for rejection or dismissal from employment.
I authorize obtaining information from any person(s), employers, educational
institutions, licensing authorities, and/or law enforcement agencies concerning
my background, work habits, skill or conduct on the job, with the exception of
past employer(s) I have indicated that are not to be contacted. I hereby
release such person or entities from all liability for damages for issuing such
information.
When I am employed I agree that if at any time I make claims for personal
injuries, I will submit myself, upon written request, to examination by a
physician or physicians of employer's selection, at employer's expense, as
often as may be requested.
I also agree that if I am employed, now or at any time in the future, my
employment may be terminated at any time without liability to me for wages or
salary except for such wages or salary which I earned prior to the date of my
termination. I understand the term of my employment shall be limited to the
duration of any assignmentÊ that I accept.
I am aware that Public Law 91-508, known as the Fair Credit Reporting Act,
requires the employer to inform me that a routine inquiry may be made
that will provide applicable information concerning my character, my
general reputation, my personal characteristics and my credit history.
Upon written request, I will provide additional information as to the
nature and scope of the inquiry or any report which is produced.
I understand that I am applying for temporary or contract assignments. The
completion of the this application process shall constitute a conditional offer
of employment subject to my availability and the availability of customer
assignments calling for the skill and qualifications that I possess, and I
agree to consider acceptance of such assignments.
Please take a moment to review your application. Indicate that you have
read the above statement by entering your initials in the box below. To
complete this application, click on the Submit Application button.
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