Revised: May 2018
I understand the County of Monroe requires a criminal background check prior to commencing any work if I should accept
an offer of employment for any County opening in which I may be considered. I further understand if a job offer is made,
employment may be contingent upon the successful completion and passage of a medical exam.
I authorize a thorough investigation of all statements contained in this application (and accompanying resume, if any). I
also authorize Monroe County to contact my present employer (unless otherwise noted in this application form), past
employers, educational institutions and any or all references listed without giving me prior notice of such disclosure. I
hereby release the County of Monroe and their representatives from any and all liabilities arising out of or in any way
related to such investigation or disclosure.
I authorize any person, school, current or previous employer, and organizations named in this application form (and
accompanying resume, if any) to provide Monroe County with relevant information and opinion (including, but not limited
to Personnel file materials, disciplinary materials and performance evaluations) that may be useful to Monroe County in
making a hiring decision, and I release such persons and organizations from any legal liability in making such statements.
I understand that neither this document nor any offer of employment from Monroe County constitute an employment
contract. I also understand that if I am hired, either Monroe County or I may terminate my employment with Monroe
County at will for any or no reason, at any time.
I understand that if my employment is terminated by Monroe County for dishonesty, breach of trust, or any criminal acts,
the authorities may be notified and I may be criminally prosecuted. I also understand that, if hired, I may not hold other
employment, nor engage in sales, investments or other activities that create a conflict of interest with my position with
Monroe County.
I certify that the information provided in this empl
oyment application (and accompanying resume, if any) is true and
complete, and I understand that any false information or significant omissions may disqualify me from further
consideration for employment, and may result in my dismissal from employment, if discovered at a later date. I agree to
immediately notify Monroe County if I should be convicted of a felony, or any crime involving dishonesty or a breach of
trust while my job application is pending, or during my employment with Monroe County, if hired.
My typed name has the same force and effect as my written signature.
Signature of Applicant
Date
This application for employment shall be considered active for a period of six (6) months and will remain on file for two
(2) years.