Date Format: MM slash DD slash YYYY
Professional Licenses And/Or Certifications
List current (or most recent) employer first and all others in reverse chronological order.
List Three Personal References (Not Relatives)
- This institution does not discriminate in hiring or any other decision on the basis of race, color, sex, citizenship, national origin, ancestry, Vietnam era veteran status, or on the basis of age or physical or mental disability unrelated to ability to perform the work required. No question on this application is intended to secure information to be used for such discrimination.
I voluntarily give The Elizabeth Scott Community the right to make a thorough investigation of my past employment and activities, agree to cooperate in such investigation and release from all liability or responsibility all persons, companies or corporations supplying such information. I consent to take the physical examination, and such future physical examination, and such future physical examinations may be required by this institution at such times and places as the institution shall designate. I understand that an offer of employment may be contingent on passing the physical examination (to include drug screen), which relates to the essential duties that I would be required to perform.
I understand that all potential Elizabeth Scott Community employees must successfully complete a background check (to include finger printing) and physical examination (to include drug testing).
I understand that my employment is at will, and that either party is free to terminate the employment relationship at any time without cause. I also understand that my employment may be terminated for any misstatement or omission of fact appearing on this application form.
If employed, I will be required to complete an Employment Verification Form (I-9), and within three days show satisfactory evidence of identity and eligibility for employment.
This job application will be kept active on file for 90 days