GENERAL JOB APPLICATION
Are you 18 or older?
Are you a citizen of the United States?
Type of Position Applying for:
If not, are you legally allowed to work in the United States?
I certify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquires of my personal, employment, educational, financial, and other related matters as may be necessary for an employment decision. I hereby release employers, schools or individuals from all liability when responding to inquires in connection with my application.
In the event I am employed, I understand that false and misleading information given in my application or interview(s) may result in discharge.
I hereby consent to submit to urinalysis and/or other tests as shall be determined by McCoy Grading, Inc. in the selection process of applicants for employment, for the purpose of determining the drug content thereof.
I agree that a lab designated by McCoy Grading, Inc. may collect these specimens for these tests and may test them or forward them to a testing laboratory designated by the company for analysis.
I agree that a diluted negative test result or any specimen that appears to be tampered with or suspicious will be treated as a positive test result and applicant will be responsible for the cost of the test, which is $110.00. The company will rely on the opinion of the testing laboratory as to the status of specimens submitted.
I further agree to and hereby authorize the release of the results of said test to the company.
I understand that it is the current use of illegal drugs that prohibits me from being employed at this company.
I further agree to hold harmless the company and its agents (including the above named physician or clinic) from any liability arising in whole or part, out of the collection of specimens, testing, and us of the information from the said testing connection with the company’s consideration of my application of employment.
I further agree that a reproduced copy of this pre-employment consent and release form shall have the same force and effect as the original.
I have carefully read the foregoing and fully understand its contents. I acknowledge that my signing of this consent and release form is a voluntary act on my part and that I have not been coerced into signing this document by anyone.