Boys & Girls Clubs Kennebec Valley Employment Application

(If any, give dates, position, location)

(If any, give dates, positions)

HAVE YOU BEEN CONVICTED OF, PLEAD GUILTY TO, AND/OR PLED NOLO CONTENDRE TO A CRIME (FELONY OR MISDEMEANOR, INCLUDING BUT NOT LIMITED TO SEXUAL OFFENDER CRIMES, THEFT, BANKING FRAUD, DRUG AND/OR ALCHOHOL-RELATED OFFENSES, ASSAULT, ETC.)?

(state, date, court, type of crime, place of occurrence, disposition):

(Approximate percentage if position indicates)

AUTHORIZATION TO RELEASE EMPLOYMENT REFERENCE INFORMATION I understand that Boys & Girls Clubs of Kennebec Valley (BGCKV) will attempt to verify statements made on my application and made during my employment interview. I hereby give my permission for my former employers to answer any and all questions based upon information available to them in my prior employment records. I understand that it is possible that my prior employment records may not be accurate. Nonetheless, in consideration of BGCKV’s review of this application and my candidacy for employment, I release BGCKV and all former employers from any liability as a result of the furnishing and receiving of this reference information. I understand that my failure to sign this reference release so BGCKV can contact references and make a full background check of my previous work history will be deemed interference with and a withdrawal of my application for employment.

AUTHORIZATION TO RELEASE EMPLOYMENT REFERENCE INFO. I understand that Boys & Girls Clubs of Kennebec Valley (BGCKV) will attempt to verify statements made on my application and made during my employment interview. I hereby give my permission for my former employers to answer any and all questions based upon information available to them in my prior employment records. I understand that it is possible that my prior employment records may not be accurate. Nonetheless, in consideration of BGCKV’s review of this application and my candidacy for employment, I release BGCKV and all former employers from any liability as a result of the furnishing and receiving of this reference information. I understand that my failure to sign this reference release so BGCKV can contact references and make a full background check of my previous work history will be deemed interference with and a withdrawal of my application for employment.

I understand that Boys & Girls Clubs of Kennebec Valley (BGCKV) requires certain information about me to evaluate my qualifications for employment and conduct its business if I become an employee. I understand that false, incomplete, or misleading statements on this application may be considered sufficient cause for rejection of my application and for dismissal, if discovered after I am employed by BGCKV. The use of this application blank does not indicate there are positions open and does not in any way obligate BGCKV. I also authorize BGCKV to supply information about my employment record, in whole or in part, in confidence to any prospective employer, government agency, or other party having a legal and proper interest, and I hereby release BGCKV from any and all liability for its providing this information. I understand that I have the right to make a written request within a reasonable period of time for a complete and accurate disclosure of additional information concerning the nature and scope of this investigation. In consideration of my potential employment, I agree to conform to the rules of BGCKV. I understand that I have the right to terminate my employment at any time with or without notice, with or without cause, and that BGCKV has a similar right. I understand my employment by BGCKV does not constitute a guarantee that any position be continued for any length of time or that any job assignment or shift be permanent. I understand that I may be required to work scheduled and unscheduled overtime and scheduled weekend and holiday work when required by BGCKV. I also understand that BGCKV has the right to modify its policies without giving me any notice of the changes. No promises regarding employment have been made to me. I understand that no one other than the President of BGCKV has authority to make any other agreement. The Immigration Reform and Control Act of 1986 requires that, after employment, employers verify the legal work authorization and identity of all new employees. An offer of employment will depend upon BGCKV’s ability to verify this necessary information. Applications will not be considered active after the position is filled. I understand that BGCKV will attempt to verify statements made on my application and made during my employment interview.