COLLEGE OR UNIVERSITY
Please list your present and past work experience for the last 10 years, beginning with your current job. You may include volunteer activities.
Please submit a resume if you were unable to include all relevant employment history. OPTIONAL
I hereby certify that the information contained in this application form is true and correct to the best of my knowledge and agree to have any of the statements checked by CITY AMBULANCE OF EUREKA, INC., (hereafter “CAE”), unless I have indicated to the contrary. I authorize the references listed above, as well as all other individuals whom CAE contacts, to provide CAE, any and all information concerning my previous employment and any other pertinent information that they may have. Further, I release all parties and persons from any and all liability for any damages that may result from furnishing such information to CAE as well as from any use or disclosure of such information by CAE or any of its agents, employees, or representatives. I understand that any misrepresentation, falsification, or material omission of information on this application may result in my failure to receive an offer or, if I am hired, my immediate dismissal from employment. In consideration of my employment, I agree to conform to the rules and standards of CAE. I further agree that my employment and compensation can be terminated at will, with or without cause, and with or without notice, at any time, either at my option or at the option of CAE. I understand that no employee or representative of CAE, other than its president, has the authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing. Further, the president of CAE may not alter the at-will nature of the employment relationship unless the president and I both sign a written agreement that clearly and expressly specifies the intent to do so. I agree that this constitutes an integrated agreement with respect to the at-will nature of my employment relationship, that it is final and fully binding, and that there are no oral, written, or collateral agreements regarding this issue. I understand that CAE resolves any and all employment-related disputes, including those relating to the application/hiring process, pursuant to the alternative dispute resolution procedures set forth in its Arbitration Policy. Accordingly, I understand that CAE and I waive any rights to a jury trial as to such disputes, and agree to resolve any and all employment-related disputes in accordance with the CITY AMBULANCE OF EUREKA, INC. Arbitration Policy, a copy of which will be made available upon request. Further, the employer and I waive any right we may otherwise have to prosecute claims as a class member or participant in a representative class or collective action, (with the sole exception of claims brought under the Private Attorneys General Act of 2004 (“PAGA”)) and may bring a claim under this policy only in an individual capacity. I also understand that all offers of employment are conditioned on the provision of satisfactory proof of an applicant's identity and legal authority to work in the United States, as well as the satisfactory completion of a post-offer medical examination.