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From / ToJob TitleAddressTelephone Number(s):SupervisorReason for leaving:Job Duties:EmployerCandidate's Name
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From / ToJob TitleAddressTelephone Number(s):SupervisorReason for leaving:Job Duties:If you need additional space, please continue on the back or on a separate sheet of paper.State any additional information you feel may be helpful to us in considering your application.REFERENCES:1.(Name) (Phone #)(Address)2.(Name) (Phone#)(Address)3.(Name) (Phone#)(Address)Applicants Statement - must be read and signedI certify that answers given herein are true and complete to the best of my knowledge.I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision, including direct contact with people listed by me as references.This application for employment shall be considered active for a period of time not to exceed 6 months. Any applicant wishing to be considered for employment beyond this time period should contact the Human Resources Office of Northeast College of Health Sciences.I hereby understand and acknowledge that, unless otherwise defined by applicable law or another official college document, any employment relationship with this organization is of an at will nature, which means that the Employee may resign at any time and the College may discharge the Employee at any time with or without cause. It is further understood that this at will employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.In the event of employment, I understand that false or misleading information given in my application, resume or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the College.Signature of Applicant Date