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I understand that if I am employed, any misrepresentation or material omission made
by me on this application will be sufficient cause for cancellation of this application
or immediate discharge from the employer's service, whenever it is discovered.
I give the employer the right to contact and obtain information from all references,
employers, educational institutions and to otherwise verify the accuracy of the
information contained in this application. I hereby release from liability the employer
and its representatives for seeking, gathering and using such information and all
other persons, corporations or organizations for furnishing such information.
The employer does not unlawfully discriminate in employment and no question on this
application is used for the purpose of limiting or excusing any applicant from consideration
for employment on a basis prohibited by local, state or federal law.
If I am hired, I understand that I am free to resign at any time, with or without
cause and without prior notice, and the employer reserves the same right to terminate
my employment at any time, with or without cause and without prior notice, except
as may be required by law. This application does not constitute an agreement or
contract for employment for any specified period or definite duration. I understand
that no representative or the employer, other than an authorized officer, has the
authority to make any assurances to the contrary. I further understand that any
such assurances must be in writing and signed by an authorized officer.
I understand it is this company's policy not to refuse to hire a qualified individual
with a disability because of that person's need for a reasonable accommodation as
required by the ADA.
I also understand that if I am hired, I will be required to provide proof of identity
and legal work authorization.
I represent and warrant that I have read and fully understand the foregoing and
seek employment under these conditions.
BACKGROUND CHECK PERMISSION FOR PROSPECTIVE EMPLOYEE: I hereby authorize all corporations,
companies, credit agencies, schools, government agencies, persons, military services, and
former employers to release information they may have about me to HealthCare Partners
Management Services Organization or its agents and employees, and release all persons or
companies from any liability or responsibility from doing so. Further, I authorize the
procurement of a consumer report and credit check (if applicable), and understand that
such a report may contain information about my background, character, and personal reputation.
I understand that this notice will also apply to any future update reports that may be requested.
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