certify that the statements I have made are true and correct and without
material omission. I understand that making false statements or omitting
pertinent facts is sufficient cause for rejection or dismissal from employment.
I authorize obtaining information from any person(s), employers, educational
institutions, licensing authorities, and/or law enforcement agencies concerning
my background, work habits, skill or conduct on the job, with the exception of
past employer(s) I have indicated that are not to be contacted. I hereby release
such person or entities from all liability for damages for issuing such
also agree that if I am employed, now or at any time in the future, my
employment may be terminated at any time without liability to me for wages or
salary except for such wages or salary which I earned prior to the date of my
termination. I understand the term of my employment shall be limited to the
duration of any assignment that I accept.
am aware that Public Law 91-508, known as the Fair Credit Reporting Act,
requires the employer to inform me that a routine inquiry may be made that will
provide applicable information concerning my character, my general reputation,
my personal characteristics and my credit history. Upon written request, I will
provide additional information as to the nature and scope of the inquiry or any
report which is produced.
Premier Staffing, Inc. is an equal employment opportunity employer. We adhere to
a policy of making employment decisions without regard to race, color, religion,
sex, sexual orientation, national origin, citizenship, age or disability. We
assure you that your opportunity for employment with Premier Staffing, Inc.
depends solely on your qualifications.