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I certify that the statements I have made are true
and correct and without material omission. I understand
that making false statements or omitting pertinent
facts is sufficient cause for rejection or dismissal
from employment. I authorize obtaining information
from any person(s), employers, educational institutions,
licensing authorities, and/or law enforcement agencies
concerning my background, work habits, skill or conduct
on the job, with the exception of past employer(s)
I have indicated that are not to be contacted. I hereby
release such person or entities from all liability
for damages for issuing such information.
When I am employed I agree that if at any time I
make claims for personal injuries, I will submit myself,
upon written request, to examination by a physician
or physicians of employer's selection, at employer's
expense, as often as may be requested.
I also agree that if I am employed, now or at any
time in the future, my employment may be terminated
at any time without liability to me for wages or salary
except for such wages or salary which I earned prior
to the date of my termination. I understand the term
of my employment shall be limited to the duration
of any assignment
that I accept.
I am aware that Public Law 91-508, known as the Fair
Credit Reporting Act, requires the employer to inform
me that a routine inquiry may be made that will provide
applicable information concerning my character, my
general reputation, my personal characteristics and
my credit history. Upon written request, I will provide
additional information as to the nature and scope
of the inquiry or any report which is produced.
I understand that I am applying for temporary or
contract assignments. The completion of the this application
process shall constitute a conditional offer of employment
subject to my availability and the availability of
customer assignments calling for the skill and qualifications
that I possess, and I agree to consider acceptance
of such assignments.
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