PLEASE READ CAREFULLY BEFORE YOU SIGN (OR TYPE) YOUR INITIALS
AND SIGNATURE
I hereby certify that I have not knowingly withheld any information that might adversely affect my
chances for employment and that the answers given by me are true and correct to the best of my
knowledge. I further certify that I, the undersigned applicant, have personally completed the application.
I understand that any omission or misstatement of material fact on this application or on any document
used to secure employment shall be grounds for rejection of this application or for immediate termination
if I am employed, regardless of the time elapsed before discovery
I authorize American Scribes, LLC to investigate the information in this application and my resume, and
further authorize any person or institution, including my current employer (except if noted otherwise
above) to provide AS with records, information, and opinions that may be useful in making a hiring
decision, and I release all such informants from all liability for any damage that may result from
furnishing information and opinion that is truthful or made in good faith.
If I become employed, I agree to abide by the rules, regulations, policies and procedures of AS.
I understand that nothing contained in the application, or conveyed during any interview that may be
granted or during my employment, if hired, is intended to create an employment contract between me
and AS. In addition, I understand and agree that if I am employed, my employment is for no definite or
determinable period and may be terminated at any time, with or without prior notice, at the option of
either myself or AS, and that no promises or representations contrary to the foregoing are binding on AS
unless made in writing and signed by me and AS's CEO.
I understand that this position requires a background screening, and may include a credit report.
Should a search of public records (including records documenting an arrest, indictment, conviction, civil
judicial action, tax lien or outstanding judgment) be conducted by internal personnel employed by AS, I
am entitled to copies of any such public records obtained by AS unless I mark the check box below. If I
am not hired as a result of such information, I am entitled to a copy of any such records even though I
have checked the box below.
If offered employment, I understand that I will be required to review, complete and execute various
employment documents, including but not limited to, this application, employee handbook and its receipt
form, and confidentiality and non-disclosure agreements. I agree that the process of my being hired will
not be complete until all employment documents have been signed
I understand that should I receive an offer of employment, it will be contingent upon and not limited to
the results of pre-placement requirements, which include a physical exam, drug test screening and
thorough background check.
I understand that I will be required to possess a valid United States driver's license if my job requires me to drive in the course of my work
Signature
