Employment Application

ANSWERING YES TO THESE QUESTIONS DOES NOT CONSTITUE AN AUTOMATIC REJECTION FOR EMPLOYMENT. DATE OF OFFENSE, SERIOUSNESS, NATURE OF VIOLATION, REHABILITATION, AND POSITION APPLIED FOR WILL BE CONSIDERED.

PREVIOUS EMPLOYMENT

(BEGIN WITH MOST RECENT POSITION)

PREVIOUS EMPLOYMENT #2

PREVIOUS EMPLOYMENT #3

BY SUBMITTING THIS FORM, I CERTIFY THAT MY ANSWERS ARE TURE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I AUTHORIZE YOU TO MAKE SUCH INVESTIGATIONS AND INQUIRIES OF MY PERSONAL, EMPLOYMENT, EDUCATIONAL, FINANCIAL AND OTHER RELATED MATTERS AS MAY BE NECESSARY FOR AN EMPLOYMENT DECISION. I HEREBY RELEASE EMPLOYERS, SCHOOLS OR INDIVIDUALS FROM ALL LIABILITY WHEN RESPONDING TO INQUIRIES IN CONNECTION WITH MY APPLICATION. IN THE EVENT I AM EMPLOYED, I UNDERSTAND THAT FALSE OR MISLEADING INFORMATION GIVEN IN MY APPLICATION OR INTERVIEW MAY RESULT IN DISCHARGE. APPLICANTS WILL BE SUBJECT TO RANDOM DRUG AND ALCOHOL TESTING.