Hospice of Siouxland Applicant Acknowledgement


To the best of my knowledge, all of the information I have submitted on this application is true and complete. I understand that any omission or falsification of information will be sufficient cause for disqualification from further consideration for employment or for dismissal.

I voluntarily give this organization the right to make a thorough investigation of my personal or past employment history and education, agree to cooperate in such investigation, and authorize any former employer, person, firm, or corporation to give this organization any information
they may have regarding me. In consideration of this organization’s review of this application, I release this organization and all providers of information from any liability as a result of furnishing and receiving this information. I understand that any offers of employment are contingent on successful completion of the post-offer exam and background checks.

I understand employment at this organization is “at will,” which means employment may be terminated by the employee or by this organization at any time, with or without cause. I further understand employee benefits, terms and conditions of employment and the policies, procedures and work rules of the organization may be determined, changed and modified from time to time by this organization without limitation or agreement. I also understand any employment handbooks or manuals that may be distributed to me by this organization shall not be construed as a contract.

I hereby agree that if I become employed by this organization I consent to the release of all my future educational records involving classes, coursework, seminars and all other educational programs in which I am enrolled or attend and for which a portion or all of the enrollment fee or tuition will be paid by this organization to an accredited higher education institution. This consent will be effective on my date of employment and until I specifically revoke it in a signed and dated writing delivered to the higher education institution.

I verify that I have read and understand the Nondiscrimination Policy. *

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Hospice of Siouxland https://hospiceofsiouxland.com
Signature Certificate
Document name: Hospice of Siouxland Applicant Acknowledgement
lock iconUnique Document ID: 841c2be5183320e2df3da91d7ee168b98e131c60
Timestamp Audit
April 26, 2020 3:31 pm CSTHospice of Siouxland Applicant Acknowledgement Uploaded by Adam Cory - Corya@hospicemail.com IP 67.4.202.46, 127.0.0.1
April 27, 2020 9:05 pm CSTAndrew S - ajsykes92@gmail.com added by Adam Cory - Corya@hospicemail.com as a CC'd Recipient Ip: 67.4.202.46, 127.0.0.1
April 28, 2020 9:26 pm CSTAndrew S - ajsykes92@gmail.com added by Adam Cory - Corya@hospicemail.com as a CC'd Recipient Ip: 67.4.202.46, 127.0.0.1
April 28, 2020 9:26 pm CSTBrenda S - SmalleyB@hospicemail.com added by Adam Cory - Corya@hospicemail.com as a CC'd Recipient Ip: 67.4.202.46, 127.0.0.1