Attestation, Disclaimer, and Signature
Community Health Center of Southeast Kansas, Inc. (CHC/SEK) is an equal opportunity employer. In employment, CHC/SEK does not discriminate because of race, color, religion, sex, gender, sexual orientation, national origin, ancestry, disability, marital status, or age. Required fields are marked with an asterisk (*).
Attestation: I certify and attest that my answer are true and complete to the best of my knowledge, without consequential omissions of any kind whatsoever. If this application leads to my employment at CHC/SEK, I understand that false or misleading information in my application or interview may result in the termination of my employment at CHC/SEK.
I understand that the Immigration Reform and Control Act of 1986 requires all employers to verify IDENTITY and EMPLOYMENT AUTHORIZATION for all employees, and that CHC/SEK may take all necessary steps to verify my IDENTIFY and EMPLOYMENT AUTHORIZATION.
I hereby authorize any educational institution and my former employers to provide any information they may have regarding me.
I understand that a conditional offer of employment may be based on results of an investigative background check and a later health assess/examination.
If employed by CHC/SEK, I hereby agree to be paid in accordance with the Fair Labor Standards Act, and that the Fair Labor Standards Act provides that an employee (myself) may be paid every two (2) weeks.
If employed by CHC/SEK, I hereby agree to abide by the policies, protocols, and rules of CHC/SEK. That CHC/SEK and the employee (myself) have a right to freely enter into the employment relationship and sever the relationship at any time, for any reason. Accordingly, I understand that any employment, by CHC/SEK, is not for a stated period of time and may be terminated, with or without cause, at any time, at the option of either CHC/SEK or the employee (myself).
In the event that CHC/SEK should be or become subject to the conditions of the Drug-Free Workplace Act of 1988, I agree to abide by such established policies as related thereto.
Disclaimer: I agree that CHC/SEK shall not be liable in any respect if my employment is terminated because of false statements, answers, or omissions made by me in this application or interview.
I disclaim and release educational institutions and their employees, former employers and their employees, and CHC/SEK and its employees from any and all liability, whatsoever, for providing, obtaining, exchanging, and/or discussing information and documentation associated with my educational background and work experience.
Signature: By signing my name below, I agree with and to the contents, terms, and conditions of the Attestation and the Disclaimer immediately above. In the event I had any questions about the Attestation and the Disclaimer, I understand that by signing my name immediately below that I am freely and openly stating that I no longer have any questions regarding the Attestation and the Disclaimer, that I had any questions answered to my liking, and that I agree with and to the contents, terms, and conditions of the Attestation and the Disclaimer.