I hereby certify I have not knowingly withheld any information which might adversely affect my chances of employment and the answers given by me are true and correct to the best of my knowledge. I further certify I, the undersigned applicant, have personally completed this application. I understand any omission or misstatement of material fact on this application or any documents used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery. DMV reports will be obtained for any employee who is authorized to drive on company business. I hereby authorize Revasum to procure such reports as deemed appropriate to evaluate my insurability under the company’s insurance coverage.
I hereby authorize Revasum to thoroughly investigation my references, former employers, work record, education, certifications, training records, and any and all other persons and organizations for information bearing upon my qualifications and suitability for employment. I further authorize the listed employers, schools, and personal references to give Revasum any and all letters, reports, and other information, about my previous employment and education, along with any other pertinent information they may have, without giving me prior notice of such disclosure. In addition, I hereby release Revasum, my former employers and all other persons, corporations, partnerships, and associations from any and all claims, demands, or liabilities arising out of or in any way related to such investigation or disclosure.
I hereby understand and acknowledge any employment relationship with this organization is of an “at will” nature, which means that I may resign at any time and Revasum may terminate my employment at any time with or without cause. It is further understood this “at will” employment relationship may not be changed by written documentation, oral communication, or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. I further understand this is an application for employment and no employment contract is being offered. I also understand that nothing conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and Revasum.
I certify, under penalty of perjury, that all of the above information is true and complete, and I understand that any falsification or omission of information may result in denial of employment or, if hired, may result in termination.
Typing my name and information below serves as my electronic signature (in accordance with the "ESIGN Act") and indicates that I agree with the above statements.