Custom Form


PLEASE PRINT CLEARLY. Fill out employment application completely and be sure to sign when completed. You may submit one application for each job posting for which you are interested. An original signature will be required on each employment application.





Please read the following statements carefully and indicate your understanding and acceptance by signing in the space provided.

I understand this application is not an employment contract, nor can it be used to create one. Volunteerism by HACS, Inc. has no specific term and may be terminated by the volunteer or HACS, Inc. with or without notice. I acknowledge that HACS, Inc. has not made any promises or representations that differ from those contained in this paragraph. I certify that all the information provided by me in connection with my application, whether on this document or not, is true and complete, and I understand that any misstatement, falsification, or omission of information may be grounds for refusal to accept as a volunteer, to hire, or if hired, termination. I understand that as a condition of volunteerism, I will be required to provide legal proof of identity. If I am offered a volunteer position with HACS, Inc., and fail to provide this evidence will result in the termination of my volunteerism. I understand that HACS, Inc. may conduct background inquiries on me by requesting information from various federal, state, city, and/or other agencies which maintain records concerning my past activities relating to my driving, credit, criminal, civil, and other experiences as well as claims involving me in the files of insurance companies. I hereby authorize HACS, Inc. to request a criminal and/or civil background report. I understand that HACS, Inc. may utilize any information received in determining my eligibility for volunteerism. This authorization and consent shall be valid in original, fax, or copy form. I authorize any of the persons or organizations referenced in this application to give you any and all information concerning my previous employment, education, or any other information they might have, personal or otherwise, with regard to any of the subjects covered by this application, and I release all such parties from all liability from any damages which may result from furnishing such information to you.