PRE-EMPLOYMENT CHECKS AND TESTING
Equal Opportunity Employer
TOWN OF PLAINVILLE
HUMAN RESOURCES DEPARTMENT
1 CENTRAL SQUARE
PLAINVILLE, CT 06062
AT-WILL EMPLOYMENT DISCLAIMER AND APPLICANT'S
AGREEMENT AND CERTIFICATION
I certify that the answers given in this application are true to the best of my knowledge.
I understand that the use of this application form does not indicate that there are any positions open and does
not in any way obligate the Town of Plainville.
I understand that should I be granted an interview, no representations that may be made at the interview are
to be construed as creating any obligation, promise or contract on behalf of the Town. Further, in
consideration of my employment, I agree to conform to the policies and procedures of the Town, as
they may from time to time be implemented or revised, and that, subject to any applicable collective
bargaining agreement, my employment and compensation can be terminated with or without cause,
and with or without notice, at any time, for any lawful reason or for no reason at all at the option of
either the Town or myself. It is further understood that this “at-will” employment relationship may not be
changed by any written document or by conduct unless the Town Manager specifically acknowledges such
change in writing. I understand that no supervisory, management or any other employee of the Town has any
authority to make a commitment of guaranteed or continuing employment to me, and no document or
publication of this Town should be interpreted to make such a guarantee.
I understand that false or misleading information given in my application, resumes, interview(s) or during the
course of my employment may result in withdrawal of a job offer or discipline up to and including termination of
employment, whenever the omission or falsehood is discovered.
I understand that acceptance for employment shall depend on satisfactory replies from my references and
other background checks. In the event I receive a job offer, I also understand that I will be subject to a drug
test and/or a medical examination that I must pass before I commence work.
I have read, understood and agree to the foregoing.
Applicant’s Signature: __________________________________________Date: __________________
Please note, if completing this form as a fillable PDF, typing your name will serve as your
e-signature. Please check this statement to signify reading and understanding this statement.