I attest to the truth and accuracy of all information I have provided on this application and it is understood and agreed that any misrepresentation by me or omissions of fact on this application will be sufficient cause for rejection of my application and/or termination of my employment, if I have become employed. I give the company the right to investigate all references and to secure additional information about me, if job related. I hereby release the company and its representatives from any liability for seeking such information, as well as all other persons, corporations or organizations for furnishing such information to Human Services, Inc.

Humans Services, Inc. is an equal opportunity employer and will not base hiring decisions on race, sex, national origin, religion, disability, age, or any other protected characteristic under applicable local, state, or federal laws. Human Services, Inc. does not discriminate in employment and no question on this application is used or intended to be used for the purpose of limiting or excluding any applicant’s consideration for employment on any basis prohibited by applicable local, state or federal law.

This application is current for only 60 days. At the conclusion of this time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to fill out a new application.

I understand that Human Services, Inc. is an “employer at-will” and that if I become employed by the company just as I will be free to resign at any time, the employer reserves the right to terminate my employment at any time, with or without cause and without prior notice. I understand that no representative of the company has the authority to make any assurance to the contrary.

I understand it is Human Services, Inc.’s policy not to refuse to hire a qualified individual with a disability because of this person’s need for an accommodation that would be required by the ADA.