PLEASE READ THE FOLLOWiNG STATEMENT CAREFULLY BEFORE SIGNING
I authorize investigation of all statements contained in this application. I understand that falsification, omission, or misrepresentation of facts called for may result in termination or the removal of my application from consideration. I authorize Southwest Distributors, Inc. to obtain information about my experience with former employers. I authorize those parties to provide information about my experience and I release those parties from any liability arising there from. I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d).
I understand that I have the right to 1) review information provided by previous employers; 2) have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; 3) Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information. I understand that nothing set forth in this employment application or in the granting of an interview is intended to create an employment contract between Southwest Distributors, Inc. and myself for employment.
If Southwest Distributors, Inc. employs me; I agree to conform to the rules and regulations of Southwest Distributors, Inc. I also agree and understand that wages, hours and working conditions are subject to change by Southwest Distributors, Inc. at any time, with or without notice. I understand that all employment at Southwest Distributors, Inc. is on an at-will basis. That means that Southwest Distributors or myself can terminate the employment relationship at any time, with or without notice, and with or without cause. I understand that only the president of Southwest Distributors, Inc. has the authority to enter into any agreement contrary to the foregoing and then only in writing.
I understand that a physical examination and drug and alcohol-screening test may be required after a conditional offer of employment is extended. I understand that refusal to take a physical examination, including drug and alcohol screening test, refusal to submit a blood or urine sample for testing, or refusal to sign an authorization form may result in disqualification for employment. I authorize any physician or hospital to release any information, which may be necessary to determine my ability to perform the duties of a job for which I am being considered.
I certify that I have read and that I understand the foregoing, and acknowledge that no offer or promise of employment has been made. I also certify that to the best of my knowledge, the information contained herein is true, correct, and complete.
Southwest Distributors, Inc. considers applications for only a sixty, (60) day period. If you wish to be considered after sixty, (60) days, please reapply.