Describe Work Limitations
Vocational/Technical School
Graduate/Professional School References List three personal, professional or academic references whom we may contact. (not former employers or relatives)
Employment (Beginning with the most recent. Include self-employment, military, summer, part-time)
General Questions or Comments
UNDER MARYLAND LAW AN EMPLOYER MAY NOT REQUIRE OR DEMAND ANY APPLICANT FOR EMPLOYMENT OR PROSPECTIVE EMPLOYMENT OR ANY EMPLOYEE TO SUBMIT TO OR TAKE A POLYGRAPH, LIE DETECTOR OR SIMILAR TEST OR EXAMINATION AS A CONDITION OF EMPLOYMENT OR CONTINUED EMPLOYMENT. ANY EMPLOYER WHO VIOLATES THIS PROVISION IS GUILTY OF A MISDEMEANOR AND SUBJECT TO A FINE NOT TO EXCEED $100.00
DISCLAIMER BY ENTERING NAME(ELECTRONIC SIGNATURE) AND DATE AND SUBMITTING THIS FORM, I CERTIFY THAT THE INFORMATION I HAVE GIVEN IN MY APPLICATION AND INTERVIEW(S) IS TRUE AND COMPLETE AND THAT I HAVE NOT WITHHELD ANY FACTS WHICH MIGHT EFFECT MY APPLICATION. I AUTHORIZE THE INVESTIGATION OF ALL INFORMATION CONTAINED IN MY APPLICATION, STATEMENTS MADE DURING INTERVIEWS AND ANY OTHER INFORMATION PERTINENT TO MY EMPLOYMENT AND RELEASE FROM LIABILITY OR RESPONSIBILITY ALL PERSONS AND CORPORATIONS REQUESTING OR SUPPLYING SUCH INFORMATION. I UNDERSTAND THAT ANY MISREPRESENTATION OR OMISSION OF FACT IS SUFFICIENT CAUSE FOR REJECTION OF THIS APPLICATION OR DISCHARGE IF I AM LATER EMPLOYED. I ALSO UNDERSTAND THAT I AM REQUIRED TO ABIDE BY ALL RULES AND REGULATIONS OF THIS COMPANY AND UNDERSTAND THAT MY EMPLOYMENT AND COMPENSATION CAN BE TERMINATED, WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE AT ANYTIME AT THE OPTION OF EITHER THE COMPANY OR MYSELF. ONCE A JOB OFFER IS EXTENDED, THE JOB OFFER IS CONTINGENT ON PROVIDING PROOF THAT I AM LEGALLY PERMITTED TO WORK IN THIS COUNTRY.