Maria Cuca's Employment Application
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Notice to applicant:
We are an equal opportunity employer and do not discriminate on the basis of an applicant's or employee's race, color, religion, sex, national origin, citizenship, age, physical or mental disability or any other characteristic.
Location *
Date
*
MM
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DD
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YYYY
Last Name *
First Name
*
Middle Name
Social Security Number  *
Address (Street address, City, State, Zip) *
Phone Number  *
Position Applied For  *
Full time or Part time  *
Expected pay rate *
Employment History (List Current Fist) *
Emergency Contact (Name-Relation-Phone number)  *
Acknowledgement (please read carefully)
I hereby certify that the information contained in this application form and in any attachments listed below (hereinafter made a part of this application) is true and correct to the best of my knowledge and agree to have any of the statements checked by the organization unless I have indicated to the contrary. I authorize the references listed above to provide the Company any and all information concerning my previous employment and any pertinent information that they may have. Further. I release all parties and persons from any and all liability for any damages that may result from furnishing such information to the Company as well as from the use or disclosure of such information by the organization or any of its agents, employees, or representatives. I understand that any misrepresentation, falsification, or material omission of information on this application may result in my failure to receive an offer or. if I am hired, in my dismissal from employment.

I also understand and agree that:

1) If employed, I am to work faithfully and diligently, to be careful and avoid accidents, and to comply with all present and subsequently issued Company rules and policies;

2) This application is not an offer of employment and nothing contained in this application, any employee handbook, policy manual, or other Company correspondence or document, or in granting an interview is intended to create a contract between the Company for either employment or the provision of any benefit;

3) No promises of employment have been made to me, and I understand that no such promises or guarantees are binding on the Company untess made in writing, and signed by its President, and no manager, supervisor, or representative of the company, except ils President, has the authority to enter into any agreement for employment for any specified period of time or to make any agreemen contrary to the foregoing;

4) If employed. I understand and agree that my employment is "at will" and for no definite period and that, regardless of the time and manner of payment of my wages or salary, my employment and compensation may be terminated at any time, at the option of either the Company or myself with or without cause and/or with or without any previous notice.
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