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Please compile all certifications into one document.
I certify that the information contained in this application is correct to the best of my knowledge, and I understand that falsification of this information is grounds for refusal to hire or, if hired, dismissal. I authorize any of the persons or organizations referenced in this application to give you any and all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application and release all such parties from all liability for any damage that may result from furnishing such information to you. I authorize you to request and receive such information. In consideration for my employment and my being considered for employment by Ephraim City, I agree to conform to the rules and regulations of Ephraim City and acknowledge that these rules and regulations may be changed, interpreted, withdrawn, or added to by Ephraim City at any time, at the City’s sole option and without any prior notice to me. Potential employees may be requested to provide a specimen for drug testing. I understand that by signing this application I am giving Ephraim City authorization to test. A medical review officer will review all positive tests. Test results are confidential. Ephraim City will pay fees for all required drug testing. I acknowledge that I have been advised that this application will remain active only for the time period in which the position I applied for remains open. I authorize investigation of all statements contained in this application and an investigation of my background, including any and all criminal history records and driver’s license history. I understand that the findings of the investigation may or may not bar me from employment with Ephraim City.
Your electronic signature below indicates your agreement with the following statements: By typing my name in the following box and clicking submit button I certify the above statements to be true and correct, to the best of my knowledge, and that this information can be used for the purpose of processing my employment application and information.
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