Employment Application Date *
Date Format: MM slash DD slash YYYY Name * Email Address *
Phone * Present Address Permanent Address Are You 18 or Older? If Not, Can you Submit Work Permit? Are you Drug Free and Can you Pass a Drug Screeing? Are you Legally Authorized to Work in the United States? Date You Can Start *
Date Format: MM slash DD slash YYYY Referred By: Salary Desired Education Graduated Work Experience – Please Provide Dates. Companies, Addresses, Positions Days and Hours Available for Work Total Hours Desired per Week Do You Have a Valid Drivers License? Have you Ever Been Convicted of a Crime? If Yes, Please Explain Applicant’s Statement – Please read and sign. I hereby certify that the information contained in this application form is true and correct to the best of my knowledge and agree to have any of the statements checked by the company unless I have indicated to the contrary. I authorize the references listed above to provide the company any and all information concerning my previous employment and any pertinent information that they may have. Further, I release all parties and persons from any and all liability for any damages that may result from furnishing such information to the company as well as from any use or disclosure of such information by the company or any of its agents, employees, or representatives. I understand that any misrepresentation, falsification, or material omission of information on this application may result in my failure to receive an offer or, if I am hired , in my immediate dismissal from employment.In consideration of my employment, I agree to conform to the rules and standards of the company, as amended from time to time in the company’s sole discretion. I further agree that my employment and compensation can be terminated at will, with or without cause, and with or without notice, at any time, either at my option or at the option of the company. I understand that no employee or representative of the company, other than the president of the company, has any authority to enter into any agreement for employment for any specified period of time, or to make any express or implied agreement contrary to the foregoing. Further, the president of the company may not alter the at-will nature of the employment relationship or enter into any employment agreement for a specified time unless the president and I both sign a written agreement that clearly and expressly specifies the intent to do so. I agree that this shall constitute a final and fully binding integrated agreement with respect to the at-will nature of my employment relationship and that there are no oral or collateral agreements regarding this issue.I specifically authorize Reflection Detail to obtain any and all employment records, reports, data, information, or copies thereof,from any of my previous employers listed above; and I further specifically authorize any previous employers to provide Reflection Detail such information that in any way relates to my employment history and performance. I also understand that all offers of employment are conditioned on the receipt of satisfactory responses to reference requests.I understand all Reflection Detail sites have video/audio security and that I may be recorded while on a Reflection Detail property; day or night; performing work related tasks or not. I hereby give Reflection Detail authorization to use any such recordings during my job performance reviews, training, criminal investigations, or any other review process Reflection Detail deems necessary. I understand such data is owned and maintained by Reflection Detail and I will not have access to or ownership of such stated data recordings at any time. I understand that Reflection Detail may keep in their possession these stated video/audio recordings for any length of time and are free to delete them, as they so desire. I understand that I will be required to provide a urine sample for alcohol and drug testing as a requirement of employment, and I hereby consent to provide a urine specimen to Reflection Detail and consent to the testing of that specimen by a laboratory chosen by Reflection Detail I further authorize the release of the test results and other related medical information to Reflection Detail management and/or to any outside reviewing agent chosen by Reflection Detail management. Type Your Signature We are an equal opportunity employer. In compliance with federal and state equal opportunity laws,qualified applicants are considered for all positions without regard to race, color, gender, national origin, age, military status, or disability, as defined by federal and state law. Thank you again for your interest in working at Reflection Detail ! If we have an opening we feel you might be able to fill, the manager of this location will contact you. We will keep this application under consideration for 45 days. After 45 days, if you are still interested, you will need to reapply. Name
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