APPLICANT STATEMENT:
PLEASE CAREFULLY READ THE FOLLOWING STATEMENT BEFORE SIGNING.
I hereby certify that all information contained in this application is true and correct to the best of my knowledge. I further certify that I have not knowingly withheld any information that may adversely affect my chances for employment. I understand that any error or omission of information may result in denial of employment or termination at any time.
I authorize all of my current and former employers and their employees, past or present, to give the Cerebral Palsy Center any and all information concerning my employment history, and any other pertinent information they may have, personal or otherwise. I also authorize that all my former schools may give the Cerebral Palsy Center any or all information concerning my education. I also authorize all of the references that I have provided to give any information to the Cerebral Palsy Center that they consider relevant. I waive all privacy interests in such information.
I further release all the sources referenced above (and all their employees, officers, directors, and agents) and the Cerebral Palsy Center (and its employees, officers, directors, and agents) of all claims and liability for any damages resulting from their furnishing any information, whether I agree or disagree with the content of the disclosed information. Thus, I understand that if any one of the above sources discloses information which I believe to be erroneous, I cannot bring any legal action against that source or the Cerebral Palsy Center regarding the disclosure of the information. In this regard, I waive any and all benefits associated with California Civil Code Section 1542, which provides, "General Release/Claims Extinguished. A general release does not extend to claims which the creditor does not know or suspect to exist in his favor at the time of executing the release, which if known by him must have materially affected his settlement with the debtor."
I also authorize the Cerebral Palsy Center (or its designated investigator) to obtain any criminal conviction records about me from any federal, state, or local law enforcement agency or court. I further release the Cerebral Palsy Center (and its employees, officers, directors, and agents) and any court or law enforcement agency, from any and all liability for any damages resulting from the furnishing of any criminal conviction information, whether I agree or disagree with the contents of the information.
If employed, I understand that my employment can be terminated with or without cause, at any time, and for any reason, or no reason, at the option of either the organization or myself. I understand that no one, other than the Executive Director of the Cerebral Palsy Center, has any authority to enter into an agreement for employment for a specified period of time, or to make any agreement contrary to the foregoing. Any agreement entered into by the Executive Director can only be made in writing signed by him/her and the employee.
I understand that the issuance of this application does not indicate that there are any positions open. I certify that I have read, fully understand, and accept all terms of the foregoing applicant statement.
