Employment Application

Maximum file size: 268.44MB

History of Employment

List your complete employment record(including temporary, regular, and part-time) in date order.
List the most recent first. Include military service if applicable.









List name and telephone number of three business/work references that are not related to you and not previous supervisors. If not applicable, list three school or personal references that are not related to you.

Reference #1

Reference #2

Reference #3

Acknowledgement of Understanding

Please read before submitting

It is understood that this application is not an obligation of employment.

I hereby authorize Oak Hill to investigate all references/former employment, and to perform background checks. I understand that information obtained in this authorized investigative report and background investigation may result in not being offered a position of employment. I hereby release and hold harmless any person, firm, or entity that discloses information in accordance with this authorization, as well as from liability that might otherwise result from the request for use of and/or disclosure of any or all of the foregoing information except with respect to a violation of the Act. I authorize Oak Hill and its designated agent and all associated entities to receive any criminal history information pertaining to me in the files of any state or local criminal justice agency. I authorize all corporations; companies; former employers; supervisors; credit agencies; educational institutions; law enforcement/ criminal justice agencies; city, state, county and federal courts; state motor vehicle bureaus; and other persons and entities to release information they may have about me to Oak Hill or their designated agent.

Upon an offer of employment, I agree to take a drug test; participate in fingerprinting for a background check; complete a physical examination and a work study evaluation. I realize that an offer of employment is contingent upon the results of these screenings and that Oak Hill reserves the right to withdraw an offer of employment should I fail to successfully pass or complete any of the aforementioned screenings.

I also understand that Oak Hill reserves the right to withdraw any offer of employment or consideration for employment, or discharge an employee, upon finding falsification, misrepresentation, or omission of fact on an employment application, resume, or other attachments, as well as in verbal statements, regardless of when it is discovered.

I will provide proof of my eligibility to work within 3 business days as required by “The Immigration Reform and Control act of 1986”.

I understand that Oak hill can make no guarantee as to the numbers of hours that I may be assigned from week to week, and any reduction in hours can affect my compensation and benefits. I also understand that I may be required to change days off and scheduled hours on a temporary or regular basis in order to continue my employment. Also, I understand that Oak Hill reserves the right to transfer me, as business necessitates, and my continued employment may be predicated upon my acceptance of said transfer. I understand that evenings or weekends may be part of any schedule I may be assigned.

I understand that my employment is not governed by any written or oral contract and is considered an “at will” arrangement. I understand that I am free, as is Oak Hill, to terminate employment at any time for any reason, so long as there is no violation of applicable Federal or State law.

I also agree to notify Oak Hill if any of the information in this employment application changes including information about criminal activity, licensure discipline or exclusion changes.

I state that the information on this application is true and complete. I agree that I have read and understand the above acknowledgements and agreements and recognize all of the above as conditions of employment.