Applicant's StatementInitial each item after reading.
1. The information that I have provided on this application is accurate to the best of my knowledge and may be verified by Independent Community Living or its agents.
2. I authorize all the schools, persons, and organizations named in this application to provide any relevant information in their possession or knowledge to the agents of Independent Community Living, for use in deciding whether or not to offer me employment and specifically waive any required written notification. I hereby release Independent Community Living, my former employers and all other persons from any and all claims, demands, or liabilities arising out of or in any way related to such injury or disclosure.
3. I understand that Independent Community Living is committed to maintaining a drug and alcohol free work place. Accordingly, I may be subject to a pre-employment blood test, urinalysis or other drug/alcohol screening. I further understand that if employed, I may be subjest to such a drug and alcohol screening if Independent Community Living has reasonable suspicion to believe that I am under the influence of a drug or alcohol. My consent to submit to such a test is required as a condition or employment and my refusal to consent shall result in a refusal to hire or, if already employed, termination.
4. I understand and agree that any misrepresentation or omission of facts in this application will be justification for refusal or termination of employment, regardless of the time elapsed before discovery.
5. I understand and agree that the employment for which I am making application is, and is intern to be, at-will, and such employment may be terminated at any time with or without cause, without prior notice, by either myself, or Independent Community Living. There will be no agreement, express or implied between Independent Community Living and me for any specific period of employment.
My signature and information in the spaces below signifies that I have completed the entire application to the best of my ability and have carefully read the foregoing six (6) statements.