EMPLOYMENT APPLICATION DISCLAIMER and RELEASE OF INFORMATION AUTHORIZATION

(Please Read Carefully Before Submitting)

I certify that all statements given on this application and all other information provided are true and accurate, and I understand that falsification, omission, or misrepresentation in this or any other personnel record can result in my termination, if hired.  I authorize verification of all statements contained in this application (and the accompanying resume, if any).  I authorize the City of Holly Springs to contact my present employer (unless otherwise noted in this application form), past employers, and listed references.  I authorize any person, school, current or previous employer, and organizations including state, local, or federal law enforcement authorities to provide the City of Holly Springs with relevant information regarding my work history and personal background, and I release the City of Holly Springs, and all other such persons and organizations from any legal liability in connection with the request for and release of such information.  

I understand that the City of Holly Springs may seek additional information concerning my credit, character, and general reputation by obtaining an investigative consumer report pursuant to the Fair Credit Reporting Act.  I understand that the City of Holly Springs will inform me in writing when such a report is requested, and that I have a right to request that the reporting agency provide me with the details of the report.

I understand that due to the nature of services provided by the City of Holly Springs, every precaution is taken to ensure that finalist candidates pose no potential risk to agency clients and employees.  I authorize the City of Holly Springs to conduct any and all such background investigations as it deems necessary, including but not limited to, an investigation of police records and a protective services background check.  I further understand that the City of Holly Springs is a drug-free workplace, and if I am a finalist candidate for a position, I agree to participate in a drug screening test (at agency expense and at a location to be selected by the agency) prior to a formal offer of employment.  I understand that an offer of employment is contingent upon a negative test result. 

I agree that if I am offered employment by the City of Holly Springs and accept, my employment will be employment “at will” and that my employment, compensation, and benefits can be terminated, with or without cause, and with or without notice, at any time, at the option of either the City of Holly Springs or me.  I understand that neither this application nor any other personnel form will constitute a contract for employment.  I am hereby informed and I understand that no representative of the City of Holly Springs other than the Mayor and Board of Aldermen has any authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing and that any such agreement must be in writing and must be signed by one of these authorized individuals.  If hired, I agree, as a condition of employment, to keep confidential and not disclose to anyone all information acquired during employment which is of a confidential, proprietary, or privileged nature.  I hereby agree to sign and abide by any confidentiality agreement presented to me if I am offered employment with the City of Holly Springs.

I understand that the City of Holly Springs is an Equal Opportunity Employer and does not discriminate in employment.  It is understood that no question on this employment application is used for the purpose of limiting or excusing any applicant’s consideration for employment on a basis prohibited by local, state, or federal law.  I also understand that it is the policy of the City of Holly Springs not to refuse to hire a qualified individual with a disability because of this person’s need for any accommodation as required by the Americans with Disabilities Act.