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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 the Company and ADP TotalSource® 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
the Company or ADP TotalSource (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(ies) 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 THE
COMPANY OR ADP TOTALSOURCE 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 THE BASIC EMPLOYMENT POLICIES, PERSONNEL
HANDBOOK OR ANY PERSONNEL MANUALS) CONSTITUTES AN EMPLOYMENT CONTRACT OR
MODIFICATION OF THE AT-WILL EMPLOYMENT RELATIONSHIP BETWEEN ME AND THE COMPANY
OR ADP TOTALSOURCE.
I ALSO UNDERSTAND THAT MY AT-WILL EMPLOYMENT STATUS WITH THE COMPANY MAY ONLY
BE ALTERED IN AN INDIVIDUAL CASE OR GENERALLY IN A WRITING SIGNED BY THE OWNER,
PRESIDENT OR CEO OF THE COMPANY AND THAT MY AT-WILL STATUS WITH ADP
TOTALSOURCE MAY ONLY BE ALTERED IN AN INDIVIDUAL CASE OR GENERALLY IN A WRITING
SIGNED BY THE PRESIDENT OF ADP TOTALSOURCE.
I understand that 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 Company and ADP TotalSource to release the results of
background checks (if any) and my pre-employment drug/alcohol test (if any), any information on this
application and any relevant information about me to each other and to other ADP TotalSource clients for
whom I have applied for employment, and release the Company, ADP TotalSource and its clients from
any and all claims related to the lawful release of this information. I further 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.