APPLICANT CERTIFICATION
I understand that the Company may now have, or may establish, a drug-free work place or drug and/or
alcohol testing program consistent with applicable federal, state, and local law. If the Company has
such a program and I am offered a conditional offer of employment, l understand that if a
pre-employment (post-offer) drug and/or alcohol test is positive , the employment offer may be
withdrawn. I agree to work under the conditions requiring a drug-free workplace, consistent with
applicable federal, state, and local law. I also understand that all employees of the location,
pursuant to the Company's policy and federal, state. and local law may be subject to urinalysis
and/or blood screening or other medically recognized tests designed to detect the presence of
alcohol or illegal or controlled drugs. If employed, I understand that the taking of alcohol and/or
drug tests is a condition of continual employment and I agree to undergo alcohol and drug testing
consistent with the Company's policies and applicable federal, state, and local law.
I f employed by the Company, I understand and agree that the Company, to the extent permitted by
federal, state, and local law, may exercise its right, without prior warning or notice, to conduct
investigations of property (including, but not limited to, files, lockers, desks, vehicles, and
computers) and, in certain circumstances , my ·personal property.
I understand and agree that as a condition of employment and to the extent permitted by federal,
state, and local law, I may be to sign confidentiality, restrictive covenant, and/or conflict of
interest statement, as well as an agreement to arbitrate.
I certify that all the information on this application, my resume, or any supporting documents I may
present during any interview is and will be complete and accurate to the best of my knowledge. I
understand that any falsification, misrepresentation, or omission of any information may result in
disqualification from consideration for employment or, if employed, disciplinary action, up to and
including immediate dismissal.
THIS COMPANY IS AN AT-WILL EMPLOYER AS ALLOWED BY APPLICABLE STATE LAW. THIS MEANS THAT
REGARDLESS OF ANY PROVISION IN THIS APPLICATION, IF HIRED, THE COMPANY OR I MAY TERMINATE
THE EMPLOYMENT RELATIONSHIP AT ANY TIME, FOR ANY REASON, WITH OR WITHOUT CAUSE OR NOTICE.
NOTHING IN THIS APPLICATION OR IN ANY DOCUMENT OR STATEMENT, WRITTEN OR ORAL, SHALL LIMIT
THE RIGHT TO TERMINATE EMPLOYMENT AT-WILL. NO OFFICER, EMPLOYEE OR REPRESENTATIVE OF THE
COMPANY IS AUTHORIZED TO ENTER INTO AN AGREEMENT- EXPRESS OR IMPLIED-WITH ME OR ANY
APPLICANT FOR EMPLOYMENT FOR A SPECIFIED PERIOD OF TI ME UNLESS SUCH AN AGREEMENT IS IN A
WRITTEN CONTRACT SIGNED BY THE PRESIDENT OF THE COMPANY.
IF HIRED. I AGREE TO CONFORM TO THE RULES AND REGULATIONS OF THE COMPANY, AND I UNDERSTAND THAT THE
COMPANY HAS COMPLETE DISCRETION TO MODIFY SUCH RULES AND REGULATIONS AT ANY TIME, EXCEPT THAT IT
WILL NOT MODIFY ITS POLICY OF EMPLOYMENT AT-WILL.
I authorize the Company or its agents to confirm all statements contained in this application and/or
resume as it relates to the position I am seeking to the extent permitted by federal, state, or
local law. I agree to complete any requisite authorization forms for the background investigation
which may be permitted by federal, state and/or local law. If applicable, I will receive separate
written notification regarding the Company's intent to obtain "consumer reports."
I authorize and consent to, without reservation, any party or agency contacted by this employer to
furnish the above mentioned information. I hereby release, discharge, and hold harmless, to the
extent permitted by federal, state, and local law, any party delivering information to the Company
or its duly authorized representative pursuant to this authorization from any liability, claims,
charges, or causes of action which I may have as a result of the delivery or disclosure of the above
requested information. I hereby release from liability the Company and its representative for
seeking such information and all other persons, corporations, or organizations furnishing such
information. Further, if hired, I authorize the company to provide truthful information concerning
my employment to future employers and hold the company harmless for providing such information.
If hired by this Company, I understand that I will be to provide genuine documentation establishing
my identity and eligibility to be legally employed in the United States by this Company. I also
understand this Company employs only individuals who are legally eligible to work in the United
States.
THIS APPLICATION WILL BE CONSIDERED ACTIVE FOR A MAXIMUM OF SIXTY (60) DAYS. IF YOU WISH TO BE CONSIDERED
FOR EMPLOYMENT AFTER THAT TIME, YOU MUST REAPPLY.