Please complete the below skills checklist. Select 1, 2 or 3 on
ONLY those skills that apply to you.
(1 = GOOD, 2 = AVERAGE, 3 = POOR)
AUTHORIZATION
By initialing here
I agree that I have been informed of the requirements of the work for which I am applying, and that the information on the application is correct and complete to the best of my knowledge. I understand that it shall be grounds for immediate dismissal if any of the information contained herein is found to be untrue. I authorize you and all former employers, given by me as references, to answer all questions and to give all information in connection with this application for in, any way concerning me. I understand that if accepted for employment I will be working for you, on your payroll, at your clients premises. I agree that I will obtain your permission before discussing permanent employment with your client. I agree to immediately notify you at the conclusion of each assignment or as soon as I become available. If I fail to give such notice, you may assume that I am not available for re-assignment, and am not ready, willing and able to work. I understand that any information I learn while working for a client is the be kept confidential. I agree to take a drug & alcohol test if I have a workman's comp injury while your employee. I agree if employed by you, that if i ever make claims against you for personal injuries, upon your request I shall submit to examinations by physicians of your selection. I will hold you harmless from any claims including, but not limited to, personal injury or illness as a result of my providing false or misleading information on this application. I hereby acknowledge that my employment is "at will", that I may resign at any time and the company may terminate my employment at any time, with or without cause.
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