Read the Following Statements Before Signing this Application
I voluntarily give this facility the right to make a thorough investigation of my past employment, including my past training session and inservice attendance, attendance, attendance record, and disciplinary actions. I agree to cooperate in such an investigation and release from all liability or responsibility this facility, and all persons, companies or corporations supplying such information.
I consent to take physical examinations as may be required by this facility at such times and places as the facility shall designate.
I understand that I will be required to follow the personnel policies and rules of the facility and that infractions of the rules may lead to dismissal.
I understand that this facility follows the "Fair Employment Practice code", and there is no discrimination in the hiring of individuals unrelated to ability to perform the work required.
I understand that if I am employed, it will be on a probationary or trial basis for a period of 640 hours. Upon my termination I authorize the release of reference information on my work.
I understand that unforeseen conditions may require me to temporarily work shifts other than the one for which I am applying and agree to such scheduling change as directed by my department head or administrator of this facility.
I understand that this application will remain on file for six months from today's date and if I wish to be considered for training or employment consideration after that time, I need to update this application.
If a job offer is made to me, I understand that it is contingent upon taking and passing a physical exam.
I understand that my training or employment may be terminated for any misstatement or omission of fact appearing on this application form.
