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Please provide the following requested information regarding your employment history. You may exclude organization names that include race, color, religion, gender, national origin, ancestry, age, disability or other protected status.
Current or Most Recent Employer
2nd Previous Employer
3rd Previous Employer
College or University
Use this section to list languages you speak other than English and your proficiency level in each.
Please list all volunteer work you have participated in: (You may exclude any volunteer work which would reveal gender, race, national origin, age, disability, or other protected status.)
Please provide the following requested information regarding personal references. Please list character references and NOT a relative or former employer.
Where did you learn about GBCH&FM
By my signature below, I affirm that the information provided in this employment application is true and complete. I understand that if employed, and false information or omissions shall be considered sufficient cause for dismissal without any obligation or liability to me other than for payment, at the rate agreed upon, for services actually rendered. I agree to immediately notify GBCH&FM if I should be charged with, convicted of, or plead guilty or nolo contendere to a felony of any kind, or any crime involving dishonesty or breach or trust, or any crime against a minor, or any crime involving an allegation of sexual misconduct or impropriety.
I authorize the investigation of all statement contained in this application. I also authorize GBCH&FM to contact my present employer (unless otherwise noted in this application form), past employers and listed references and other references that might know of my qualifications for employment. I authorize any person, school, current employer, past employer(s), and organizations to provide GBCH&FM with any information and opinions, whether or not documented, and I hereby release them from any legal liability in providing such information.
I understand and agree that, if offered a job, I may be required to submit to a drug/alcohol test at the time of the offer and at any time during employment. If not employed, this application will be retained for 24 months for future reference. (If employed, the employment application will become part of your personnel file.)
I UNDERSTAND AND ACKNOWLEDGE THAT, UNLESS OTHERWISE DEFINED BY APPLICABLE LAW, ANY EMPLOYMENT RELATIONSHIP WITH THIS ORGANIZATION IS OF AN 'AT WILL' NATURE, MEANING THAT THE EMPLOYEE MAY RESIGN AT ANY TIME AND THE EMPLOYER MAY DISCHARGE EMPLOYEE AT ANY TIME WITH OR WITHOUT CAUSE. IT IS FURTHER UNDERSTOOD THAT THIS 'AT WILL' EMPLOYMENT RELATIONSHIP MAY NOT BE CHANGED BY ANY WRITTEN DOCUMENT OR BY CONDUCT UNLESS SUCH CHANGE IS SPECIFICALLY ACKNOWLEDGED IN WRITING BY AN AUTHORIZED EXECUTIVE OF THIS ORGANIZATION.
I also understand that applications submitted electronically, via e-mail or similar media, are not valid unless I enter my name in the signature field below and such action shall constitute an electronic signature.
An authorization for a motor vehicle report, and a criminal records check will be signed at or following the interview. If you are employed, an immigration verification and a physical examination will be required.