Co-Workers, Friends, Etc.

Former Employers or Supervisors

Please read and complete your application carefully. Your qualifications will be carefully reviewed and you will be considered for suitable vacancies in the company. If you are employed, this application will become a part of your personnel record. Keep this in mind as you fill it out. You are reminded that you are not required to give any information prohibited by Federal, State or Local law.

No question on this application is asked for the purpose of limiting or excluding consideration of persons for employment because of race, religion, color, sex, disability or handicap, national origin, veterans' status, or age, as may be provided by Federal, State or Local law.

I understand that I may be subject to immediate termination in the event any statement in this application is discovered to be false.

I agree to comply with all the rules of this Company. I hereby affirm and declare that all statements are true and correct, and that I have not knowingly withheld any fact that would, if disclosed, affect my application unfavorably. I hereby authorize the Company to conduct any investigation it deems necessary of the information in this application. I also hereby authorize this Company to release such information, together with their opinions on these matters, without any liability for any damage whatsoever caused either directly or indirectly by giving such information or opinions. I authorize any former employer, present employer, school, college or university, railroad, common carrier, utility company, personal reference and/or any other person or persons to give any information they may have concerning my character and employment record. I hereby unconditionally release any named or unnamed informant from any and all liability resulting from the furnishing of this information.

I understand that employment by the Company is conditioned on submission by me of verification of my legal right to work in the United States as required by Federal Law.

I understand that periodic personnel interviews are administered to all Dimples employees by our Company management or an authorized representative. The interview will cover areas of morale, attitude toward the Company, suggested changes in policy and procedures, as well as input regarding the effectiveness of management. The Company encourages open, honest communication through participation in these interviews.

I further understand that Dimples sometimes uses a polygraph procedure in connection with an ongoing investigation involving economic loss or injury to Dimples business, such as theft, embezzlement, misappropriation, or an act of unlawful industrial espionage or sabotage.

I understand Dimples is an “at will” employer and Dimples or the employee can terminate employment at any time for any reason.

I hereby authorize Company and/or any entity directed by Company to investigate my personal history academic/ professional credentials, military service records, criminal, driving, financial and credit record through any investigative or credit bureau of Company’s choice. A “consumer credit report” includes any information regarding my credit worthiness, credit standing, credit capacity. I understand and agree that a consumer credit report may be obtained at any time, and any number of times, as Company in its sole discretion determines is necessary before, during or after my employment. I further understand and agree that Company may release information obtained in this investigation to any Client (i.e. hospital, daycare, etc.) with whom I may be working.

I understand that as a condition of employment, I may be required to undergo and successfully pass a screening for alcohol and/or drugs. I also understand and agree that, if employed, I may be required to submit to an alcohol or drug screening at any time at the discretion of Dimples. I hereby consent to having the results of any such alcohol or drug screening I may be required to undergo disclosed to Dimples.