APPLICATION FOR EMPLOYMENT

APPLICATION FOR EMPLOYMENT
We are an Equal Opportunity Employer and will not unlawfully discriminate on the basis of race, color, sex, religion, helght, weight, national origin, age, marital or veteran status, arrest record, or the presence of a medical condition or handicap. We are a drug free workplace.
PERSONAL
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)
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(not applicable in California)
EMPLOYMENT DESIRED
Michigan law requires employers to make accommodations to qualified handicapped applicants and employees where the employee makes their need known to the employer, requests accommodation and such accommodation dose not impose and undue hardship on the employer.
EDUCATION
High School
College
Graduate
Vocational/Training
REFERENCES
(Do not include relatives or former employers)
References 1
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)
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MILITARY SERVICE RECORD (Optional)
ADDITIONAL INFORMATION
Handicapped employee and applicants may request an accommodation of their handicap by notifing the Company in writing of the need for accommodation within 182 days of the date the handicapper knows or should know that an accommodation is needed. Failure to properly notify the Company will preclude any claim that the employer failed to accommodate the handicapper.
COMPLETE EMPLOYMENT HISTORY
List current or most recent job first; add additional pages if necessary.
Employer 1
Dates
Hourly Rate / Salary
AUTHORIZATION AND UNDERSTANDING
IMPORTANT – To validate this application, all applicants must read the following and acknowledge the same by signing below.
Upon the signing of this application, I represent that all of the information now or hereafter given by me in support of my application is true and complete. I authorize the Company to verify any of the information concerning my employment, education, or credit history with the appropriate individuals, companies, institutions or agencies, and I authorize them to release such information as the Company requires, including any record of disciplinary action, without any obligation to give me written notice of such disclosure. I also authorize the Company to release any information requested by any of my perspective or subsequent employers without any obligation to give me written notice of such disclosure. I hereby release the Company and such other third parties form any liability whatsoever as a result of any such inquiries and disclosures. I agree that any false of incomplete information which causes my application to be misleading may subject me to discharge at any time during the period of my employment. I acknowledge that any offer of employment extended by the Company is contingent upon the results of a physical examination and drug test satisfactory to the company in its sole discretion and upon my acceptance of such offer of employment I authorize and consent to such examination and drug test. I understand that the results of such examination and drug test shall be maintained on separate medical forms and in medical files and that such confidential information shall only be disclosed to managers, supervisors, first aid and/or safety personnel regarding necessary restrictions or accommodations with respect to assigned work or for safety and/or medical purposes or to Personnel Department of Company legal representatives as required in the ordinary course of business. I agree that my employment, if hired by the Company, is “at will” and either party may terminate the employment relationship, with or without cause, at any time, and further agree that this policy may only be altered in writing directed to me personally and signed by the President of the Company. I agree that I shall be bound by the other rules, policies, regulations, and terms and conditions of employment of the Company as they are from time to time changed, and no additional obligations can be imposed on the Company except those which have been acknowledged in writing, by the President of the Company. I agree that any action or suit against the company arising out of or related to my employment of termination of employment, including but not limited to claims arising under State or Federal civil right statues must be arbitrated through the procedures of the American Arbitration Association, and must be brought, if at all, within the shorter of 180 days of the event giving rise to the claim or the applicable statute of limitations, or be forever barred. I waive any limitation periods to the contrary. I further agree that the determination of a mutually agreed upon impartial arbitrator shell be binding and final upon all parties. I further agree that the costs of arbitration shall be borne equally among the parties and the arbitrator shall not have the power to change, modify or otherwise alter the terms of any written agreements or written policies of the Company, and the arbitrator’s written determination shall be based solely upon the terms of such agreements or policies.
BY SIGNING BELOW, I ACKNOWLEDGE THAT I HAVE READ, UNDERSTOOD AND AGREE TO THE ABOVE STATEMENTS.
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