Please Review and Sign Where Indicated. In making application for employment:
I certify that the information in this application is true and complete for all practical purposes. It may be verified by the facility or any affiliates. Should a position be offered and later it is found that the information is significantly untrue, incomplete, or misrepresented, I understand and agree that the facility or its affiliates are relieved of all commitments, financial or otherwise, pertinent to employment, and that I am subject to immediate discharge without recourse.
In accordance with the Privacy Act (5 U.S.C. 552a), Freedom of Information Act and the Fair Credit Reporting Act, I expressly authorize any person associated with any educational institution, past or present employer (including federal/state/local governments), any military organizations (federal or state), any law enforcement agency (federal/state/local), any credit reporting agency, any private/public medical institution or office, or any person who has personal knowledge of my character, work history and overall mode of living to RELEASE this information to the background agency for the purpose of my being considered for employment. I hereby agree to RELEASE IMI Data Search, Inc., employees, agents and any other persons or other entities from any and all liability for damages of whatever kind or nature, whether known or unknown, which may at any time accrue to me on account of 1) reliance by such persons or entities on the information submitted in my employment application, 2) reliance by such persons or entities on the information obtained pursuant to this authorization, 3) compliance with or any attempt to comply with this authorization and 4) termination of my employment based on information obtained pursuant to this authorization. I have read the above disclosure and hereby authorize a consumer report and/or investigative report be obtained as described above. I hereby authorize a copy of this RELEASE and NOTIFICATION to be as valid as the original.
I UNDERSTAND AND AGREE THAT ANY EMPLOYEE HANDBOOK WHICH I MAY RECEIVE WILL NOT CONSTITUTE AN EMPLOYMENT CONTRACT, BUT WILL BE MERELY A GRATUITOUS STATEMENT OF FACILITY POLICIES.
I understand that the facility reserves the right to require its employees to submit to blood tests or urinalyses for alcohol or drug screens, or to allow inspection of bags (including purses or briefcases) or parcels brought into or taken out of the facility. I understand that refusal to submit to a urinalysis, blood test or search, when requested to do so, may result in termination of my employment.
Compliance with this facility’s Substance Abuse Policy is a condition of employment. This facility requires that every newly hired employee be free of alcohol or drug abuse. Each offer of employment is contingent upon successfully completing a urinalysis test/screen for alcohol and drugs in accordance
with company policy. Continued employment is also contingent with the Company’s Alcohol and Drug Abuse Policy.
I UNDERSTAND AND AGREE THAT IF I AM OFFERED EMPLOYMENT BY THE FACILITY, MY EMPLOYMENT WILL BE FOR NO DEFINITE TERM AND THAT EITHER I, OR THE FACILITY WILL HAVE THE RIGHT TO TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME, WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE. I ALSO UNDERSTAND THAT THIS STATUS CAN ONLY BE ALTERED BY A WRITTEN CONTRACT OF EMPLOYMENT WHICH IS SPECIFIED AS TO ALL MATERIAL TERMS AND IS SIGNED BY ME AND THE PRESIDENT OF THE COMPANY.