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 assignment 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. |
