Applicant Authorization for Release of Information & Certification Statement
Please read carefully
I understand that neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other organizational practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of the Bladen Smart Start, or otherwise to change in any respect the employment-at will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the Executive Director of the organization. Both the undersigned and Bladen Smart Start may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the organization may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits.
I understand that this application will be active for a period of one year; after that time, if I wish to be considered for employment, I must submit a new application. I hereby authorize the Bladen Smart Start and its agents to conduct a background investigation in order to assess my eligibility for a position requiring reliability and trustworthiness. I understand that the investigation may include verification of past employment, education, criminal record check, and opinions of reference. Prior to a third-party background-check agency being used, I will be asked to sign a separate disclosure authorization. I hereby authorize all individuals, educational institutions, firms, and others named herein, except my current employer if so noted, who may have information relevant to this background investigation to disclose it and to furnish whatever detail is available concerning my qualifications (including photocopies where requested) to the Bladen Smart Start or their agents. I release all persons from liability on account of such disclosure. I authorize that a photocopy of my signature below may be used to obtain information regarding the investigation. This authorization is valid for a period of one (1) year or until employment is terminated whichever occurs first. I certify that I have given true, accurate and complete information (application, resume, work history, education, skills, etc.) to the best of my knowledge. I authorize investigation of all statements made in this application and understand that any misstatement or omission of material facts will be grounds for disqualification in the selection process or if hired, grounds for discharge. I expressly waive any right I may have to review material or information received directly from a previous employment or education institution under a promise of confidentiality.