I certify that the information provided in this application for employment is true and complete to the best of my knowledge. In the event
of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge.
I authorize investigation of all statements contained in this application and the release of any pertinent information regarding my
education, past employment history and background. I authorize the Town of Boxborough to obtain any information from schools,
employers, professional licenses, certifications, driver’s license and history (if job related), professional references and any other
information concerning knowledge, skills and abilities. This information may include, but is not limited to: academics, achievement,
performance, attendance, personal history and discipline. Further, I hereby authorize all references, persons, schools, my current
employer (if applicable) and previous employers and organizations named in this application, unless otherwise stated, to provide the
Town of Boxborough any relevant information that may be required to arrive at an employment decision. I understand that the
information released is for the Town of Boxborough’s use only.
I hereby voluntarily release, discharge and exonerate the Town of Boxborough, its agents and representatives, and any person so
furnishing information from any and all liabilities of every nature and kind arising out of the furnishing or inspection of such documents,
records and other information or the investigations made by or on behalf of the Town of Boxborough.
I understand that all appointments are probationary and that I must demonstrate my ability for continued employment. I also
understand that I must be available from time to time to work outside normal business hours, as the needs of the department require.
I understand that any offer of employment that I receive from the Town of Boxborough may be contingent upon my successful
completion of the pre-employment screening process, including, but not limited to, the Town of Boxborough receiving satisfactory
references, review of my driving history, completion of a complete criminal background check and/or a Sex Offender Record
Information (“SORI”) check, and if appropriate, pre-employment drug test, physical examination, and/or psychological screening. I
understand that any such test results will be communicated in a confidential manner.
I understand that any employment offer by the Town is conditional upon my ability to establish employment eligibility under the
Immigration Reform and Control Act of 1986 and an I9 so certifying must be completed no later than the first day of employment.
I represent and warrant that I have read and fully understand the foregoing and seek employment under these conditions.
Signature: Date:
Discrimination against any person in any practice or procedure in advertising, recruitment, referrals, testing, hiring, transfer, promotion
or any other term, condition or privilege of employment which limits or adversely affects employment opportunities because of political
or religious opinions or affiliations, or because of age, color, disability, criminal records (inquiries only), gender, genetics, military
service, national origin, ancestry, race, religion, past participation in discrimination complaints, sexual orientation, gender identity,
marital status, pregnancy, parenthood, or disability which is unrelated to the person’s occupational qualifications or any other non-merit
factor which is not a bona fide occupational qualification is prohibited.
It is unlawful in Massachusetts to require a lie detector test as a condition of employment or continued
employment. An employer who violates that law shall be subject to criminal penalties and civil liabilities.
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