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Applicant Statement

I  understand that Lawrence Health Services is committed to providing equal opportunity in all employment practices, including but not limited to selection, hiring, promotion, transfer and compensation to all qualified applicants and employees without regard to age, race, color, national origin, sex, religion, handicap or disability, or any other category protected by law.

In making this application for employment, I understand that the facility may investigate any driving record and my criminal record and that an investigative consumer report may be made, whereby information is obtained through personal interviews with my neighbors, friends or others with whom I am acquainted. This inquiry includes information as to my character, general reputation, personal characteristics, financial responsibility, and mode of living. I understand that I have a right to make a written request with­in a reasonable period of time to receive additional detailed information about the nature and scope of this investigative report.

I authorize former and present employers, work and personal references listed in the application, and any other individuals I may name, to give the facility or its designee any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release such parties from all liability for any damages that may result from furnishing same to the facility.

I understand that the facility reserves the right, to the extent permitted by law, to require a medical examination including, but not limited to, any drug screening test, urinalysis, blood test, breathalyzer, or other procedure, of any applicant or employee either prior to employment or any time during employment and I hereby give my consent to any such test or examination. I consent to the release of the results of any such test or examination to the facility.

I understand that this employment application and any other facility documents are not promises of employment. Should I be employed, I understand that my employment will be on a trial period for ninety days from the date of my hiring. I further understand that, if I am employed, I can terminate my employment with or without cause and with or without notice, at any time, and that the facility has a similar right. I understand that no manager or representative of the facility has any authority to enter into any agree­ment for employment for any specified period of time, or to make any agreement contrary to the foregoing, except that the Administrator may do so in writing.

The information given by me in this application is true and complete in all respects, and I agree that if the information is found to be false, misleading or unsatisfactory in any respect (in the exclusive judgment of the facility) that I will be disqualified from consid­eration for employment or subject to immediate dismissal if discovered after I am hired.

THIS APPLICATION WILL BE CONSIDERED ACTIVE FOR A PERIOD OF NINETY (90) DAYS. IF YOU WISH TO BE CONSIDERED FOR EMPLOYMENT AFTER THAT TIME, YOU MUST REAPPLY. DO NOT SUBMIT YOUR APPLICATION UNTIL YOU HAVE READ AND UNDER­STAND THIS STATEMENT.

By submitting your application, you hereby agree to the above statement and its terms listed within.