Provide the following information for your past four (4) employers, assignments or volunteer activities, starting with the most recent. Please do not use “See Resume”
I certify that all information I have provided in order to apply for and secure work with the DVIS is true, complete and correct.
I understand that any information provided by me that is found to be false, incomplete or misrepresented in any respect, will be sufficient cause to (i) cancel further consideration of this application or (ii) immediately discharge me from employment with DVIS whenever it is discovered.
I expressly authorize, without reservation, DVIS, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume or job interview. I specifically authorize DVIS to obtain information regarding my job performance from any of the references have identified in my application. I hereby waive any and all rights and claims I may have regarding the DVIS, its agents, employees or representatives, for seeking, gathering, and using such information in the employment process and all other persons, corporations or organizations for furnishing such information about me.
I understand that DVIS does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by applicable local, state or federal law.
I understand that this application remains current for only 60 days. At the conclusion of that time, if I have not heard from DVIS and still wish to be considered for employment, it will be necessary to reapply and fill out a new application.
If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice, and DVIS reserves the right to terminate my employment at any time, with or without cause and with or without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied, oral or written agreements to the contrary to the foregoing express language are valid unless they are in writing and signed by the employer's president.
I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.
DO NOT CHECK UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.
DVIS prohibits and will not tolerate discrimination against any applicant or employee on the basis of race, age, religion, national origin, color, gender, sexual orientation, disability, citizenship, veteran status, or any other legally protected characteristic with regard to any terms and conditions of employment.
APPLICANT VOLUNTARY SELF-IDENTIFICANTION
(CONFIDENTIAL-FOR STATISTICAL USE ONLY)
We are an equal opportunity employer and do not discriminate on the basis of race, color, religion, sex, age, national origin, disability, veteran status, sexual orientation or any other classification protected by federal, state or local law. The information below will be used only in the compilation of data for affirmative action reporting.
Completion of this data is voluntary and will not affect your opportunity for employment or terms or conditions of employment, if hired. Identification can be declared at any time prior to or, if applicable, after hire. Please return this page with your application.
PLEASE COMPLETE IN FULL: