Official Disclosure Statement:
I certify that I personally completed this application and that all of the information is true and correct to the best of my knowledge.
Authorization to Release Records
By my signature I authorize you to make such investigative inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arrivng at an employment decision. (inquiries to medical history will be made only if and after a conditional offer of employment has been made.)
I hereby release schools, employers, health care providers and other persons from all liability in responding to inquiries and releasing information in connections with my application.
In the event i am employeed by Great Lakes Heavy Haul, Inc., I understand that false or misleading information given in my application, interview or any other part of the hiring or employment process may result in the termination of my employment. In addition I understand that I am requred to abide by all rules, policies and regulations of Great Lakes Heavy Haul, Inc.
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) and (e).
I understand I have a right to:
Review information provided by previous employers
Have any errors in the information a previous employer has provided to be corrected and resubmitted
Have a rebuttal statement attached to the alleged erroneous information, if the pevious employers(s) and I cannot agree on the accuracy of the information.