IMPORTANT: PLEASE READ CAREFULLY
I certify that, to the best of my knowledge, all the information provided to Advance Medical Staffing hereforth, in this application packet
and in any future communication, is true and complete. I understand that any misrepresentation, falsification or willful omission may
result in a refusal of employment or dismissal after employment. I understand that a routine inquiry may be made during the processing
of this application so as to acquire information concerning my employment record, education, licensure, certification, general reputation,
character, background and work performance. I authorize educational institutions, employers, law enforcement authorities,
organizations and individuals having relevant information concerning me to release such information. I release all concerned from any
liability in connection therewith.
Furthermore, I understand that if I am employed, my employment and compensation can be terminated, with or without cause or notice
and at any time, at the option of either the company or myself. I understand that any employee manuals, handbooks or policy
statements that effect employment are subject to change at any time and shall not be construed as a contract or a guarantee of
continued employment. No representative of the company, other than the Chief Executive Officer of Advance Medical Staffing or one
designated by the Chief Executive Officer, has any authority to enter into any agreement for employment for any specific period of time,
or to make any agreement contrary to the foregoing.
I understand that many of the medical facilities served by Advance Medical Staffing require a physical examination and/or drug testing
of personnel and that I may be asked to participate as a condition of placement.
By submitting this Application electronically, I agree that the same constitutes my signature to this Application, and Advance Medical
Staffing may rely upon the same as an electronic signature.
© Advance Medical Staffing, rev 12-99