PLEASE ANSWER ALL QUESTIONS BELOW
The information requested is needed for a legally permissible reason, including, without limitation, national security considerations, a legitimate occupational qualification or business necessity. The Civil Rights Act of 1964 prohibits discrimination in employment because of race, color, religion, sex or national origin. Federal law also prohibits discrimination on the basis of age with respect to certain individuals. The laws of most States also prohibit some or all of the above types of discrimination as well as some additional types such as discrimination based upon ancestry, marital status or physical or mental handicap or disability.
If not, employment is subject to verification of minimum legal age.
The information provided in this Application of Employment is true, correct and complete. If employed, any misstatement or omission of fact on this application may result in my dismissal. I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future. If you decide to engage an investigative consumer reporting agency to report on my credit and personal history I authorize you to do so. If a report is obtained you must provide, at my request, the name and address of the agency so I may obtain from them the nature and substance of the information contained in the report.
ACCIDENT RECORD FOR THE PAST 3 YEARS
IF THE ANSWER TO EITHER A OR B IS YES, PLEASE GIVE DETAILS BELOW.
I understand that, as a condition of my consideration for employment with Fisher59, LLC or as a condition of my continued employment, Fisher59, LLC may obtain a consumer report that includes, but is not limited to, my creditworthiness or similar characteristics, employment history and education background, social security verification, criminal and civil history, personal interviews, workers comp claims, motor vehicle/OMV records, military records, any other public records and any other information bearing on my credit standing, credit capacity, character, general reputation, personal characteristics and trustworthiness. I understand that this authorizes a pre-screening background investigation and will remain on file and serve as an ongoing authorization for Fisher59, LLC at any time during my affiliation or employment period.
For Commercial Driver License holders, I give my consent to Fisher59, LLC to conduct a query of the FMCSA Commercial Driver's License Drug and Alcohol Clearinghouse (Clearinghouse) to determine whether drug or alcohol violation information about me exists in the clearinghouse. I understand that this consent is for multiple limited queries that will be conducted for the duration of employment.
I understand that Fisher59, LLC will utilize an outside firm or firms to assist it in checking such information, and I specifically authorize such an investigation by information services and outside entities of the company's choice. I also understand that I may withhold my permission and that in such a case, no investigation will be done, and my application for employment will not be processed further.
By initialing and dating below, I am giving my permission to Fisher59, LLC or its agents to perform any of the aforementioned checks.
By initialing and submitting this document, you are agreeing to the terms and conditions.