- JOB APPLICANT’S AGREEMENT AND CERTIFICATION
PLEASE READ CAREFULLY AND FULLY
I certify that the information given by me in this application is true and complete in all respects, and I agree that the omission of any r
e
quested and
applicable information or misrepresentation of any fact provided in this application will be sufficient reason for the Company
to
deny me employment.
I also understand and agree that should I become employed by the Company and it is later discovered I have omitted or misrepresented any fact in this
application, including any supplement thereto, or any other corporate record, the Company may immediately terminate my employment upon discovery
of such omission or misrepr
e
sentation.
I authorize the use of any information in this application to verify my statements, and I authorize the past employers, all references, and any other persons
to answer all questions asked concerning my ability to perform the essential functions of the job, character, reputation and previous employment
record. I release all such persons from any liability or damages on account of having furnished such information. I authorize the Company to conduct
any necessary background checks it deems necessary.
I authorize the Company to obtain a copy of my driving record maintained by any state that has issued a driver’s license to me within the past 10
years.
I understand that nothing contained in this application or in the granting of an interview is intended to create an employment
con
tract (express or
implied) between the Company and myself for either employment or for the providing of any benefit. No
pr
omises regarding employment have been
made to me, and I understand that no such promise or guarantee is binding upon the Company unless a written contract created for the express
purpose of altering the employee’s at-will employment status is signed by the President or a Vice President of the Company. If an employment
relationship is established, I understand that I have the right
to
terminate my employment at any time and for any reason and that the Company
retains the same right.
If I accept a conditional offer of employment from the Company, I understand that I may be requested to take a medical examination and I consent
and agree to take such medical examination. I understand that I will be asked to complete various forms in
con
nection with my conditional job offer
including a medical questionnaire. I understand that any failure on my part to fully and accurately answer all questions asked will be grounds for
withdrawing the conditional offer of employment and/or termination of employment.
I further consent and agree to submit to any lawful drug and alcohol testing that may be required either as a condition for emp
loy
ment or for continued
employment. I understand and agree that refusal to submit to such testing may result in revocation of the conditional offer of employment and/or
termination of employment.
In the event I have a disability which will affect my ability to take such medical examination and drug and alcohol testing, I will so inform the Company
prior to the administration of the examination or testing so that a reasonable accommodation can be made. Requested accommodations may
include accessible examination/testing sites, modified examination/testing conditions and accessible examination/testing formats. The Company
reserves the right to require medical documentation concerning the need for the accommodation.
I understand that policies and procedures which are issued by the Company may be revised or eliminated in whole or in part at any time.
I understand that this application will be kept on active file for 30 days from the date completed, after which time I will have
to
reapply for
employment in accordance with established Company
pr
ocedur
es.
SIGNATURE OF APPLICANT
DATE
FOR OFFICE USE ONLY
INTERVIEWER’S NAME DATE
- 4 -
I understand by checking the box, I am signing this
application electronically. I agree that my electronic
signature is the legal equivalent of my manual
signature and by checking the box I am consenting
to the terms and conditions of this application.
Please type your full name in the signature line above.
Complete and email to: jobs@unitcorp.com
date revised: 08/2021