Please read the following paragraphs carefully and acknowledge your understanding by signing your name in the space below.
Consent to Conduct Background Investigation. As a condition of, and in consideration for the company’s consideration of my application for at -will employment, I give permission to the company to investigate my personal and employment history. I understand that this background investigation will include, but not be limited to, verification of all information on this application, as well as interviews with past employers. I further give permission to the company to conduct this investigation and to discuss the results of this investigation in connection with my
application for employment.
Consent to Contact Past Employers. I give permission to the company to contact all employers listed in my application (except those specifically
excluded) for references.
I further give permission to all current or previous employers and/or managers or supervisors to discuss my relevant personal
and employment history with the company. I further waive any rights I may have to receive a copy of any written statement
provided by any of my former employers to the company. I further agree to indemnify all past employers for any liability they
may incur because of their reliance upon this release.
Consent to Contact Government Agencies. I give permission to any agent, attorney, or representative of the company to receive a copy of any
information obtained in the file
of any federal, state, or local court, government agency, law enforcement agency, or investigator concerning or relating to me. I
further consent to the release of such information and waive any right under state law concerning notification of the request for
a release of such information. In the event a state law does not provide for prospective employers to have access to information,
I hereby delegate the company as my agent for receipt of information. I understand that the scope of this investigation will be
limited to criminal and/or civil records that relate to my honesty, integrity, and/or abilities.
Cooperation with Investigation. I agree to fully cooperate in the company’s background investigation and to sign any waivers or releases that may
be necessary to
obtain access to relevant information. In the event that any former employer of federal, state, or local government agency will not
release reference information or criminal history information directly to the employer, I agree to personally request such information
to the extent permitted by law.
Falsification Statement. I understand that any falsification or willful omission of fact made in my application for at-will employment or in connection
any background investigation may be sufficient grounds for rejection of my application , or, if discovered after an offer of employment,
for immediate dismissal.
Employment “At Will”. In consideration of my employment, I agree to conform to the rules and regulations of the company, and my employment
compensation is “at will” in that they can be terminated with or without cause, and with or without notice, at any time, at the
option of either the company or myself except as otherwise provided by law. I understand that no manager or representative of
the company, other than the president of the company, has authority to enter into any agreement for employment for any specific
period of time or to make any agreement or contract to the foregoing, and that any promises to the contrary will only be relied
upon by me if they are in writing and signed by the president of the company.