Employment History
Beginning with the most recent, please fill in the name of the employer, your job title, the dates you worked, and a brief description of your job responsibilities.
Employer
Job Title
From to
Description of job and reason for leaving: (Please use the enter key when your typing reaches the right side of the text box.)
Employer
Job Title
From to
Description of job and reason for leaving: (Please use the enter key when your typing reaches the right side of the text box.)
Employer
Job Title
From to
Description of job and reason for leaving: (Please use the enter key when your typing reaches the right side of the text box.)
Additional Information
Providing this information is voluntary and will remain confidential.
Sex: Male Female
National Origin:
White
Hispanic/Latino
Black/African American
Asian
Native Hawaiian/Pacific Islander
American Indian/Alaskan Native
Multi-Racial (combination of any of these ethnicities)
Prospective employees will receive consideration on the basis of their qualification and with assurance of equal opportunity and treatment regardless of race, color, religion, sex, pregnancy, sexual orientation, national origin, ancestry, citizenship, age, physical or mental disability, or any other characteristic protected by state or federal law.
I hereby certify that the facts set forth in this employment application are true and complete to the best of my knowledge and authorize Hillsides to verify their accuracy and to obtain reference information on my work performance. I hereby release Hillsides from any/all liability of whatever kind and nature, which, at any time, could result from an employment decision, based on such information. I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal. I understand that should an employment offer be extended to me and accepted that I will fully adhere to Hillsides policies, rules and regulations. However, I further understand that neither the policies, rules, regulations of employment nor anything said during the interview process, shall be deemed to constitute the terms of an implied employment contract. I understand that any employment offer is for an indefinite duration and at-will and that either Hillsides or I may terminate my employment at any time with or without notice or cause.
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