800-809-1265info@palmettoinfusion.com

APPLICATION FOR EMPLOYMENT

PLEASE READ CAREFULLY-PRINT CLEARLY-ANSWER ALL QUESTIONS

THE QUESTIONS FOUND ON THIS FORM ARE BEING ASKED TO PROPERLY EVALUATE YOUR ABILITY AND CHANCE FOR SUCCESS IN THE POSITION IN WHICH YOU ARE APPLYING. EVERY EFFORT HAS BEEN MADE TO COMPLY WITH THE APPLICABLE FEDERAL LAW AND LAWS OF OUR STATE. WE CONSIDER ALL APPLICANTS FOR POSITIONS WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, CITIZENSHIP, AGE, MENTAL OR PHYSICAL DISABILITIES, VETERAN/NATIONAL GUARD STATUS OR ANY SIMILARY PROTECTED STATUS.

If you are under the age of 18, can you furnish a current work permit?

Are you currently subject to a non-compete provision from another employer?

Have you ever been employed here before?

Have you ever applied here before?

Are you related to anyone employed with Palmetto Infusion?

Can you travel if a job requires it?

Are you legally eligible for employment in this country?

(Proof of US citizenship or immigration status will be required upon employment)

Education
Did You Graduate?
Did You Graduate?
Did You Graduate?
Employment History

List your previous employers, assignments or volunteer activities starting with the most recent, including military experience. May we contact your previous employer(s)?

 
Professional Licenses, Registrations, and/or Certifications:

Are you being reviewed to possibly include exclusions on your professional license?

References

APPLICATION CERTIFICATION AGREEMENT:

I authorize the investigation of all statements contained in this application and release from all liability any persons or employers supplying such information, and I also release the company from all liability that might result from making the investigation.

I certify that the facts and information set forth in this application are true and complete to the best of my knowledge. I understand that falsification, misinterpretation, or omission of facts on this application (or on any required documents) will be cause for denial of employment or immediate termination of employment, regardless of when or how discovered.

I agree, if I am offered and accept a position, to conform to all existing and future company rules and regulations and I understand that the company reserves the right to change wages, hours and working conditions as deemed necessary. I ALSO UNDERSTAND THAT, IF HIRED, MY EMPLOYMENT WILL BE AT-WILL, MEANING THAT EITHER PARTY CAN END THE EMPLOYMENT RELATIONSHIP AT ANY TIME AND FOR ANY OR NO REASON.

I understand that any employment offer is contingent upon my providing valid proof of identity and eligibility to work in order to comply with

e-Verify, completing the drug test, and a background check.

I have read and reviewed the information provided in this application and the above statements. By signing this application for employment I certify that I understand all parts of it and have answered all questions completely.

By checking this box for employment I certify that I understand all parts of it and have answered all questions completely.

THIS APPLICATION IS NOT AN EMPLOYMENT CONTRACT but merely is intended to evaluate suitability for employment. We consider all applicants for positions without regard to race, color, religion, sex, national origin, citizenship, age, mental or physical disabilities, veteran/national guard status of any similarly protected status. Or any similarly protected status. It is also the policy of the company to have the option of conducting pre-employment screening before a job offer is made. If a job offer is made, employment may be contingent upon the successful completion of a medical examination, which may include providing body substance samples.

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