Provide information regarding Previous Employment beginning with the most recent Employer.
Signature - Please read carefully before checking the 'Agree' box.
I hereby affirm that the information provided on the application (and cover letter and/or resume, if any) is true and complete. I understand that any false or misleading representation or omissions made on the application or during the hiring process may disqualify me from further consideration for employment and may result in discharge even if discovered at a later date.
I understand that employment may be conditioned upon successfully passing a medical examination and that I may be required to satisfactorily complete a drug screening as a condition of employment.
I understand that if the job for which I am hired requires licensing and/or certifications, keeping such documents current and unencumbered is a continuing requirement as long as I hold the position.
I hereby authorized persons, schools, my current employer (if applicable) and previous employers and other organizations to provide this facility and its affiliates with any requested information regarding my application or suitability for employment, and I completely release all such persons or entities from any and all liability related to the providing or use of such information.
I understand that my employment is at-will which means that I may terminate the employment relationship at any time and for any reason with or without notice, and that the facility has the same right. I understand that no one has the authority to enter into any agreement contrary to the preceding sentence, except for a written agreement signed by an administrative representative of this facility and notarized.
By checking the box below, I agree to the above and my application will be submitted to Human Resources. By not checking, I will not be allowed to submit my application.