I certify that all information I have provided in order to apply for and secure work with the employer is true, complete and
correct.
I expressly authorize, without
reservation,
the employer, its
representatives,
employees or agents to contact and obtain information
from all references (personal and
professional),
employers, public agencies, licensing authorities and educational institutions and to
otherwise verify the accuracy of all
information
provided by me in this
application,
resume or job
interview.
I hereby waive any and all
rights and claims I may have regarding the employer, its agents, employees or
representatives,
for seeking, gathering and using such
information in the employment process and all other persons, corporations or organizations for furnishing such
information
about me.
I understand that the employer does not unlawfully
discriminate
in
employment
and no question on this application is used for the
purpose of limiting or excusing any applicant from
consideration
for
employment
on a basis prohibited by applicable local, state or
federal law.
I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the
employer and still wish to be considered for
employment,
it will be necessary to reapply and fill out a new application.
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 for
employment
for any specified period or definite
duration. I understand that no supervisor or
representative
of the employer is authorized to make any assurances to the contrary and
that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by
the employer's president.
I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United
States and that federal
immigration
laws require me to complete an I-9 Form in this regard.
CERTIFICATION: I hereby certify that all entries on both sides and attachments are true and complete, and I agree and
understand that any falsification of information herein, regardless of time of discovery, may cause forfeiture on my part
of any employment in the service of the County of Mathews. I understand that all information on this application is
subject to
verification and I consent to criminal history background checks as well as DMV checks. I also consent that you may contact
references, former employers and educational institutions listed regarding this application. I further authorize the County to rely
upon and use, as it sees fit, any information received from such contacts. Information contained on this application may be
disseminated to other agencies,
nongovernmental organziations
or systems on a
need-to-know
basis for good cause shaown as
determined by the agency head or designee.
DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT
I hereby certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.
Signature: __________________________________________________________________________________________ Date: _______________________________________
AN EQUAL OPPORTUNITY EMPLOYER
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