I certify that the answers given herein and during the entire application process (including but not limited to any criminal record inquiries made following this application, resumes, attachments to this application, interviews or otherwise (if applicable)) are true and complete to the best of my knowledge.
I understand that any misrepresentations, omissions of facts or incomplete answers during the application process may disqualify me from further consideration for employment. I further understand that, if employed, any misrepresentations or omissions of facts during the application process may be cause for my dismissal at any time without prior notice.
I consent to and authorize CSS Healthcare Services to contact my former employers, references, and any and all other persons and organizations for information bearing upon my qualifications for employment.
I further authorize the listed employers, schools and personal references to give CSS Healthcare Services (without further notice to me) any and all information about my previous employment and education, along with any other pertinent information they may have and hereby waive any actions which I may have against either party for providing a good faith reference.
I EXPRESSLY AGREE AND UNDERSTAND THAT, IF EMPLOYED, MY EMPLOYMENT IS NOT FOR A SPECIFIC TERM, IS BASED ON MUTUAL CONSENT AND MAY BE TERMINATED BY ME OR CSS HEALTHCARE SERVICES WITH OR WITHOUT NOTICE OR CAUSE AT ANY TIME. I FURTHER UNDERSTAND THAT NO ORAL PROMISE, EMPLOYER
POLICY, CUSTOM, BUSINESS PRACTICE OR OTHER PROCEDURE (INCLUDING PERSONNEL HANDBOOK OR ANY PERSONNEL MANUALS) CONSTITUTE AN EMPLOYMENT CONTRACT OR MODIFICATION OF THE AT-WILL EMPLOYMENT RELATIONSHIP BETWEEN ME AND CSS. I ALSO UNDERSTAND THAT THIS EMPLOYMENT IS ON A PART-TIME BASIS AND NO AMOUNT OF HOURS IS GUARANTEED. HOWEVER, MORE HOURS MAY BE ASSIGNED AS CLIENTS’ NEEDS ARISE.
ADMINISTRATIVE APPLICANTS ONLY: Full time employment may be offered depending on qualifications and
organization needs at the time of hire.
I understand I may be required to qualify for employment based on additional employment criteria. For example, I may be
required to take job-related tests; take a driver’s examination; submit to a background investigation or take a pre-employment drug test. If I am offered employment or start work before any required test is completed, I understand that my employment is contingent on a satisfactory result on all required tests. I authorize the release of any background check results and of any drug/alcohol test to any state or federal authority requesting such information and in response to a valid subpoena or other legal document. I agree to sign any additional forms necessary for pre-employment checks and/or tests to be conducted.
CERTIFICATION FOR ALL APPLICANTS – PLEASE READ CAREFULLY
This certifies that this application was completed by me, and that all entries on it and information in it are
true and complete to the best of my knowledge.