Signature
PLEASE READ CAREFULLY: I certify that the information provided by me in this application is true and complete to the best of my knowledge. I understand that any falsification, misrepresentation or omission of facts, may disqualify me for employment and may be cause for immediate dismissal, regardless of when such information is discovered.
I authorize ABC Home Healthcare Professional to investigate all statements contained in this application including but not limited to: education, employment history, criminal records, driving records.
I hereby authorize without reservation, any party or agency contacted by this employer to furnish the above-mentioned information.
I understand that employment is conditional upon verification of education, employment history, satisfactory completion of my references and background investigation. I understand that acceptance of an offer of employment does not create a contractual obligation and that either party may terminate the employment relationship, at will, at any time. I understand that within the first three (3) days of my employment I must provide proof of employment authorization and proof of identity. Failure to do so in accordance with the rules established under the Immigration Reform and Control Act will result in immediate termination of my employment.