** ANY APPLICANT FOR EMPLOYMENT WHO WILFULLY FURNISHES, SUPPLIES OR OTHERWISE GIVES FALSE INFORMATION ON AN EMPLOYMENT APPLICATION THAT IS THE BASIS FOR A CRIMINAL HISTORY RECORD CHECK UNDER THIS SECTION SHALL BE GUILTY OF A CLASS A1 MISDEMEANOR. [NCGS 131E-265(e)]










THIS INSTITUTE DOES NOT DISCRIMINATE IN HIRING OR ANY OTHER DECISION ON THE BASIS OF RACE, COLOR, SEX, CITIZENSHIP, NATIONAL ORIGIN, ANCESTRY, VIETNAM ERA, VETERAN STATUS AND/OR ON THE BASIS OF AGE OR PHYSICAL OR MENTAL DISABILITY UNRELATED TO THE ABILITY TO PERFORM THE WORK REQUIRED. NO QUESTION ON THIS APPLICATION IS INTENDED TO SECURE INFORMATION TO BE USED FOR SUCH DISCRIMINATION.

I VOLUNTARILY GIVE THIS INSTITUTION THE RIGHT TO MAKE A THOROUGH INVESTIGATION OF MY PAST EMPLOYMENT AND ACTIVITIES. I AGREE TO COOPERATE IN SUCH INVESTIGATION AND RELEASE FROM ALL LIABILITY OR RESPONSIBILITY ALL PERSONS, COMPANIES, OR CORPORATIONS
SUPPLYING SUCH INFORMATION.

I UNDERSTAND THAT MY EMPLOYMENT IS AT WILL, AND THAT EITHER PARTY IS FREE TO TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME WITHOUT CAUSE. I ALSO UNDERSTAND THAT MY EMPLOYMENT MAY BE TERMINATED FOR ANY MISSTATEMENT OR OMISSION OF FACT APPEARING ON THIS APPLICATION FORM.

IF EMPLOYED, I WILL BE REQUIRED TO COMPLETE AN EMPLOYMENT VERIFICATION FORM (I-9), AND WITHIN THREE DAYS SHOW SATISFACTORY EVIDENCE OF IDENTITY AND ELIGIBILITY FOR EMPLOYMENT.