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geographic area certification date additional please

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Unformatted text preview: ctices because of race, color, religion, sex, national origin, citizenship status, age or disability if otherwise qualified with or without reasonable accommodation. No question on this application is asked for the purpose of limiting or excluding any applicant's consideration for employment because of his or her race, color, religion, sex, national origin, citizenship status, age or disability. I certify that all the information given by me on this application or in supplemental form is true and correct to the best of my knowledge and belief. I further understand that false or misleading statements or consequential omissions of any kind on this application or supplemental forms are sufficient cause for my not being hired or my dismissal if I am hired. I understand that if I am offered employment, such offer is conditional upon the company's satisfaction with the results of my pre- employment physical or medical history inquiries. I understand that if I falsify responses to medical inquiries, including my history of worker's compensation claims, I may be terminated from employment and precluded from receiving worker's compensation benefits. I understand and agree that as a condition of employment, I will submit to an examination by a physician selected by the Company, at any time designated by the Company, which includes a urine and/o...
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