APPLICATION CERTIFICATION READ CAREFULLY BEFORE SIGNING
I certify that the information I have provided on this employment application (and accompanying resume, if any) is true and complete. I understand and agree that employment with Coastal Skin Surgery and Dermatology, if offered, may be immediately discontinued if misrepresentation, falsified statements, or material omissions are found to have been made. I authorize schools, former employers, and former supervisors to provide any and all information pertinent to my being considered for employment and hereby release those providing such information from any liability for doing so. I further understand that as a part of the procedure for my employment application, a background report(s) will be made concerning my Social Security Number, Criminal Record and/or Credit. If I am denied a job based either wholly or in part because of information contained in a background report, I will be provided the name and address of the reporting agency that supplied the information. I also understand that employment, if offered, is contingent upon my providing additional information for employee record purposes and also upon my providing proof of identity and employment eligibility and completing a Form I-9. I also understand that, if employed, Coastal Skin Surgery and Dermatology or I may terminate the employment relationship at any time, with or without cause, with or without notice, and that, if employed, employment does not constitute a contract of employment between myself and Coastal Skin Surgery and Dermatology. I will abide by and conform to all company policies, rules and procedures as may be in effect from time to time. I have read the above, understand its content and meaning, and agree to all of its provisions.
I understand that, upon my request, I will be provided a copy of my signed employment application.