All information contained in this application is true and correct to the best of my knowledge and belief.
I understand that misrepresentations or omissions of any kind may result in denial of employment or be
cause for subsequent dismissal if I am hired. I authorize the company to investigate my responses
on this application and contact any or all of my former employers or any individuals familiar with me
or my employment background for the purpose of verifying any information I have provided and/or for the
purpose of obtaining any information, whether favorable or unfavorable, about me or my employment.
I voluntarily and knowingly fully release and hold harmless any person or organization that provides
information pertaining to me or my employment. I understand that upon receiving a job offer, a physical
examination and drug screening may be required. (Note: If this is a job requirement, you will be notified.)
I understand that a job offer may be contingent upon the satisfactory results of a state criminal background
check and a review of various state and federal registries applicable to home care workers.
Regardless of whether or not I become employed by the company, I recognize that this application is not and
should not be considered a contract of employment. I understand that employment at the company is on an at-will
basis and that my employment may be terminated with or without cause, and without notice, at any time, at my
option or the company's unless specifically provided otherwise in a written employment contract.
I further understand that no company employee or representative has the authority to enter
into a contract regarding duration or terms and conditions of employment other than an officer or official
of the company, and then only by means of a signed written document. If employed I agree to abide by all the
company's rules and regulations and any changes to them. We have a policy of no smoking on the premises.
Helping Hearts LLC