Prospective employees will receive consideration without discrimination because of race, creed, color, sex, age, national origin, handicap, or veteran status.
Membership in Professional or Civic Organizations (Exclude those which may disclose your race, color, religion, sex, or national origin)
Please give accurate, complete full-time and part-time employment history. Begin with the most recent position.
Are you able to perform the essential job functions with or without accommodations? Yes No
Would you like to submit a resume?
To whom it may concern:
I authorize investigation of all information contained in my Application for Employment with Andronaco Industries.
I further authorize any present and former employer to release any and all information about me, including my personal file, to Andronaco Industries. I release my current and former employers from any obligation to provide me with written or oral notification of any of the information disclosed.
I also authorize the State Police or any local police to release any information regarding any crime for which I have been convicted or any felony for which I have been charged. I also authorized the release of my driving record to Andronaco Industries or its agent.
I authorize Andronaco Industries to obtain a credit report on me from a credit reporting agency and authorize any credit reporting agency to release a credit report concerning me.
I also authorize any person having information about me to release that information to Andronaco Industries.
I agree to sign any documents that Andronaco Industries deems necessary to complete a background investigation into my application. I understand that any false statements made by me or in my application may result in a refusal to hire or my dismissal once the facts become known.
Any photocopy of the Authorization shall be accepted with the same authority as the original.
Name
Driver's License # and State
Former Names and Alias
Birth Date (Month & Day Only)
I affirm that the facts set forth are true and complete to the best of my knowledge.
False statements in this application may result in a refusal to hire or my dismissal once the acts become known.
I further understand that hiring by the company requires a pre-employment physical examination by a company-designated physician and that hiring is contingent upon receipt of a satisfactory medical evaluation.
I recognize that this application is not an offer for a contract of employment. I further recognize and agree that if I am employed by the Company such employment will not result in a contract for employment and that the Company may terminate my services at any time for any reason or no reason at all. I further recognize that if I am employed by the Company, I will receive compensation, benefits, and be subject to rules and regulations; but I agree such compensation, benefits, rules and regulations are subject to change by the Company with or without notice to me. I acknowledge that my assigned work hours may be modified by the Company. I recognize that I will be required to work overtime as needed.
I UNDERSTAND THAT NO REPRESENTATIVE OF THE COMPANY, OTHER THAN THE PRESIDENT, HAS ANY AUTHORITY TO ENTER INTO ANY AGREEMENT FOR ANY SPECIFIC PERIOD OF TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING. ANY AGREEMENT ALTERING THE TERMINABLE AT WILL NATURE OF THE EMPLOYMENT RELATIONSHIP MUST BE IN WRITING AND SIGNED BY THE PRESIDENT AND MYSELF.
Sign
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