PLEASE READ BEFORE SIGNING.
IF YOU HAVE ANY QUESTIONS REGARDING THIS STATEMENT, PLEASE ASK BEFORE SIGNING.
I understand that the submission of this Samford University employment application does not mean that I will be offered employment
and in no way obligates Samford University. In the event of my employment, I agree to and will comply with all the rules and policies
of Samford University. I understand that such rules and policies are not contractual and may be amended or modified by Samford
University as it deems necessary. I understand that employment, if offered, is subject to my satisfying employment eligibility
requirements of the federal and state immigration laws.
I understand that either Samford University or I may terminate my employment at any time with or without notice, with or without
cause, and that Samford University does not guarantee that any position will be continued for any length of time or that any job
assignment or shift will be permanent. I also understand that no one other than the President or his designee has the authority to
enter into any agreement for employment for any specified period and such agreement must be in writing and signed by one of these
I understand Samford University will attempt to verify statements made on my application and made during my employment interview.
When contacted by Samford University, I give my permission for my former employers to answer any and all questions based upon
information available to them in my prior employment records. I understand that it is possible that my prior employment records may
not be accurate. Nonetheless, in consideration of review of this application, I release Samford University and all my former employers
from any liability as a result of the furnishing and receiving of this reference information. I understand that my failure to sign this
reference release so Samford University can contact references and make a full background check of my previous work history may be
deemed a withdrawal of my application.
I understand that I may be required to complete a separate Fair Credit Reporting Act Disclosure and Authorization form in order to
continue with the application process or as a condition of employment. I further understand that in accordance with the Alabama Child
Protection Act of 1999 a criminal records check is mandatory for persons applying for positions that will have unsupervised access to
children under the age of 19.
I certify that all statements that I make on this application and all information submitted in connection with my application for
employment is true and complete to the best of my knowledge and that I have withheld nothing that would, if disclosed, affect this
application unfavorably. I understand that giving any false, incomplete or misleading statement or misrepresentation on this application
or any information submitted in connection with my application may be considered cause for dismissal whenever discovered.
In connection with Samford University performing an investigation of the above mentioned information, I understand and hereby
authorize Samford University to conduct searches on electronic social networking sites, including but not limited to Twitter.com,
MySpace.com, Facebook.com, LinkedIn.com, Classmates.com, blogs, wikis, user-generated video and audio, and virtual worlds. I also
understand that I am giving Samford University my consent and authorization to conduct searches of the aforementioned media in
spite of any and all privacy protections that may be contained in the terms and conditions of those websites and any efforts I have
made to restrict the information from viewing by the general public or others without specific rights to access the information. I also
hereby release Samford University from any liability in connection with its use of information it finds on electronic social networking
sites and the other related electronic media referenced above. I understand that I do not have any right to privacy or any expectation
of privacy in any information that may be posted on a blog, on the web, on a social networking site or in any place that Samford
University may obtain access as a result of this release.
HAVE YOU EVER PLED GUILTY OR NO CONTEST TO, OR BEEN CONVICTED OF, PAID A FINE FOR, BEEN DIRECTED TO A
PRETRIAL DIVERSION PROGRAM, OR, IN ANY WAY ADMITTED GUILT FOR A CRIMINAL OR DISHONEST ACT, OTHER
THAN A MINOR TRAFFIC VIOLATION? □ YES □ NO IF YES, PLEASE EXPLAIN:
I hereby acknowledge that I have read and understand these statements and that the information provided on this
application is true and accurate.
SIGNATURE: ________________________________________________ DATE: ________________________________