Equal access to programs, services and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the Human Resources Department.
Comments Including Explanation Of Any Gaps In Employment
Skills and Qualifications – Summarize any special training, skills, licenses and/or certificates that may qualify you as
being able to perform job-related functions in the position for which you are applying.
List last three (3) schools attended, starting with the most recent. B. List number of years completed. C. Indicate
degree or diploma earned if any.
List name and telephone number of three business/work references who are not related to you and are not previous
supervisors. If not applicable, list three school or personal references who are not related to you.
I understand that if I am employed, any misrepresentation or material omission made by me on this
application will be sufficient cause for cancellation of this application or immediate discharge from the
employer’s service, whenever it is discovered.
I give the employer the right to contact and obtain information from all references, employers, educational
institutions and to otherwise verify the accuracy of the information contained in this application. I hereby
release from liability the employer and its representatives for seeking, gathering and using such information
and all other persons, corporations or organizations for furnishing such information.
If I am hired, I understand that I am free to resign at any time, with or without cause and without prior
notice, and the employer reserves the same right to terminate my employment at any time, with or without
cause and without prior notice, except as may be required by law. This application does not constitute an
agreement or contract or employment for any specified period or definite duration. I understand that no
representative of the employer, other than an authorized officer, has the authority to make any assurances
to the contrary. I further understand that any such assurance must be in writing and signed by an
I understand it is this company’s policy not to refuse to hire a qualified individual with a disability because of
that person’s need for a reasonable accommodation as required by the ADA.
I also understand that if I am hired, I will be required to provide proof of identity and legal work