Application for Employment

I certify that all the information on this application, my resume, and all supporting documents is correct, and I understand that any misrepresentation or omission of any information may result in disqualification from consideration for employment or, if employed, my termination. I understand that this application is not a contract, offer or promise of employment. If hired, I will be able to resign at any time, with or without cause and with or without notice. Likewise, my employment can be terminated at any time, with or without cause and with or without notice. I understand that if hired, my employment is at will.

I authorize Accident Care and Treatment Center or their agents to investigate all statements contained in this application and/or resume. I further understand that a credit and background check may be made including, but not limited to, consumer credit history, driving record, employment, military, education and general public records which will provide information concerning my character and general reputation. I hereby authorize my former employers, educational institutions and individuals named to furnish all information pertaining to my work and educational record. I release my former employers, educational institutions, supervisors, co workers and references from all liability on account of furnishing information to Accident Care and Treatment Center, and their agents.

I further release Accident Care and Treatment Center and their agents from any liability as the result of such contacts and in connection with obtaining any credit and background checks. Should a credit or background check be requested, I understand and agree that a separate authorization form will be utilized, as required by law. If required by law, a copy of this report will be provided to me. I hereby release from liability the employer and its representative for seeking such information and all other persons, corporations or organizations for furnishing such information.

I understand that Accident Care and Treatment Center may now have, or may establish, a drug free workplace, reasonable suspicion drug testing, random or a post-accident drug-testing program. If Accident Care and Treatment Center has one now or implements one in the future, and I am offered a conditional offer of employment, I agree to work under the conditions requiring a drug-free workplace and alcohol and drug testing.

I also understand and agree that I may be subject to a pre-employment, post offer medical exam, which may include urinalysis and/or blood screening or other medically recognized tests designed to detect the presence of alcohol and/or drugs as a condition of employment and/or continued at-will employment, and following any work-related injury. I agree to undergo reasonable suspicion and random drug and alcohol testing. Refusal to take such tests when asked may result in termination. I agree to post-offer, pre-employment physical exam and drug and alcohol testing. I understand this company hires only U.S. citizens or individuals who are legally eligible to work in the United States.