APPLICANT’S STATEMENT & AGREEMENT
In the event of my employment in a position in this company, I will comply with all rules and regulations of this company. I understand that the company reserves the right to require me to submit to a test for the presence of drugs in my system prior to employment and at any time during my employment, to the extent permitted by law. I also understand that any offer of employment may be contingent upon the passing of a physical examination and drug test. I consent to the disclosure of the results of any physical examination and related tests to the company. I also understand that I may be required to take other tests such as personality and honesty tests, prior to and during my employment. I understand that should I decline to sign this consent or take any of the above tests, my application for employment may be rejected or my employment may be terminated. I understand that bonding may be a
condition of hire. If it is, I will be so advised either before or after hiring and a bond application will have to be completed.
I further understand that the company may obtain Public Records about me as part of an internal background investigation.
I further understand that the Company may contact my previous employers. I authorize those employers to disclose to the Company all records and information pertinent to my employment with them. In addition to authorizing the release of any information regarding my employment, I hereby wave any rights or claims I have or may have against my former employers, their agents, employees, and representatives, as well as other individuals who
release information to the company and release them from any person or party, whether such information is favorable or unfavorable to me. I authorize the persons named herein as personal references to provide the company with any pertinent information they may have regarding me.
I hereby state that all the information that I have provided on this application or any other documents completed in connection with my employment, and in any interview is true and accurate. I have withheld nothing that would, if disclosed, affect this application unfavorably. I understand that if I am employed and any information provided to the company is found to be false or incomplete in any respect that my employment may be terminated.
If hired, I agree as follows: My employment and compensation is terminable at-will, is for no definite period, and my employment and compensation may be terminated by either the company (employer) or me at any time and for any reason whatsoever, with or without good cause.
I hereby agree that in consideration of my employment or continued employment as an at-will employee the Company and I mutually agree that the company and I will utilize binding arbitration to resolve all disputes that may arise out of the employment context. Further, the Company and I mutually agree as follows:
Any and all disputes, controversies, or claims not settled in accordance with the foregoing procedures and arising out of or relating to your application for employment, your employment, or the termination of your employment shall be settled by binding arbitration before an impartial arbitrator unless otherwise prohibited by applicable law. This provision shall apply to any and all such disputes, controversies or claims whether asserted individually by the Employee against the Company and/or against any employee, officer, alleged agent, director or affiliate of the Company with regard to any matter arising out of your employment or the termination of your employment including, but not limited to, any enforceability or breach of any employment policy, employee handbook or any purported employment agreement, and/or any claim or controversy arising out of the relationship (or the nature of the relationship) or the commencement or termination of that relationship, including but not limited to, claims for violation of a state or federal statute and/or for breach of covenant, breach of an implied covenant of good faith and fair dealing, wrongful termination, breach of contract, or intentional infliction of emotional distress, defamation, breach of right of privacy, interference with advantageous or contractual relations, conspiracy or other tort claims of any kind. Claims for discrimination, harassment, and/or retaliation arising under Title VII of the Federal Civil Rights Act of 1964, as amended Section 42 U.S.C. sections 2000(e) et. seq. and the California Fair Employment and Housing Act, California Government Code sections 12940-12950, inclusive, California Labor Code, and the Age Discrimination in Employment Act, 29 U.S.C. section 623, are subject to the provisions of this arbitration procedure. This Agreement to arbitrate applies to applicable claims that pre-exist or may pre-exist the date of this Agreement or amendment to this Agreement. The arbitration provisions of this Agreement shall provide the exclusive remedy and each party expressly waives any right he/she or it might have to seek redress in any other forum, including a trial by jury. Claims for workers’ compensation insurance or unemployment compensation benefits are not covered by this procedure. Employee shall not be precluded from filing an administrative charge with an appropriate State or Federal administrative agency for the purpose, among others, satisfying any requirement of exhaustion of administrative remedies prior to invoking this mandatory process, to seek remedies that are not victim-specific, or to otherwise permit an administrative agency to file its own lawsuit seeking statutory remedies not otherwise available in the arbitration proceeding. Employees are expressly precluded from filing and participating in any joint, class, representative, or collective claims addressing their wages, hours, or other terms or conditions of their employment against the employer in any forum, whether arbitral or judicial, except for representative claims filed under the Private Attorney General Act of 2004.
Such arbitration shall be conducted in accordance with the rules of the arbitration association or service from which the arbitrator is selected (e.g., American Arbitration ASSOCIATION, JAMS, ARS, etc.) and will be governed by the Federal Arbitration Act [9 U.S.C. Section 2, et seq.] If the employment exists in California, California Code of Civil procedure Sections 1280, et seq. will also govern such arbitration to the extent that California law is not contradictory to or pre-empted by applicable Federal law.
The arbitrator shall be selected from a list of seven (7) provided by the Office of the Federal Mediation and Conciliation Service, with the parties striking names in order and the party striking first to be determined by the flip of a coin. The arbitration shall be held in a location to be mutually agreed upon by the parties. In the absence of agreement, the arbitrator shall determine the location.
The arbitrator shall provide either party with sufficient time and access to witnesses, documentation, and records of the parties in order to conduct adequate discovery prior to initiation of the proceeding.
Any claim which either party has against the other party which could be submitted for resolution pursuant to this paragraph must be presented in writing by the claiming party to the other in accordance with applicable State or Federal statutes of limitation.
In the event either party contends that the other party’s actions are causing injury for which monetary damages would be inadequate, it may seek an injunctive order by submitting to the Office of the Federal Mediation and Conciliation Service in San Francisco a declaration under penalty of perjury setting forth the facts giving rise to its claim. Said declaration shall be served upon the other party personally or by Express Mail, Federal Express, or another comparable service, return receipt requested. If the parties are not able to agree upon a neutral arbitrator within 10 days, the Federal Mediation and Conciliation Service are authorized to select a neutral arbitrator who shall hold a hearing within 10 days of his/her selection.
The burden of proof shall at all times be upon the party seeking relief. In determining any matter, the arbitrator shall apply all applicable federal, state, and local statutory and common law, which is applicable to the dispute. The arbitration shall be conducted pursuant to the California Code of Civil Procedure’s arbitration rules, commencing at Section 1280, and the California Rules of Evidence shall apply. The arbitrator shall have the exclusive authority to resolve any dispute relating to the interpretation, applicability enforceability, or formation of this Arbitration Agreement.
The parties shall not be precluded from seeking all available remedies that would otherwise be available had the matter been litigated in court, including punitive damages and reasonable attorney’s fees.
The Company shall pay the cost of the neutral arbitrator and of a transcript of any arbitration proceeding. Each party shall bear the expense of any witnesses it calls.
Any decision and award or order of the arbitrator shall be in writing and shall be final and binding between the parties as to all claims, which were or could have been raised in connection with the dispute to the fullest extent permitted by law. The arbitrator’s decision shall be final and subject to judicial review only as provided by the California Arbitration Act (Code of Civil Procedure Section 1285, et. seq.).
If any litigation is necessary to enforce the terms of this Arbitration Agreement, or if any legal action, even though prohibited, is brought with regard to this Arbitration Agreement, the prevailing party shall be entitled to reasonable attorneys’ fees in addition to any other relief to which it may be entitled.
In the event that one or more of the provisions contained herein should for any reason be held to be unlawful or unenforceable, such unlawfulness or unenforceability shall not affect any other provision, and the procedures set forth herein shall be construed as if such unenforceable or unlawful provision had not been contained herein.
IF YOU HAVE ANY QUESTIONS REGARDING THIS STATEMENT, PLEASE ASK A COMPANY REPRESENTATIVE BEFORE SIGNING. I HEREBY ACKNOWLEDGE THAT I HAVE READ THE ABOVE STATEMENTS AND UNDERSTAND THE
SAME. MY SIGNATURE BELOW ATTESTS TO THE FACT THAT I HAVE READ, UNDERSTAND, AND AGREE TO BE LEGALLY BOUND TO ALL OF THE ABOVE TERMS. I AGREE TO SEEK EMPLOYMENT UNDER THESE CONDITIONS.
DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE STATEMENT & AGREEMENT.
I CERTIFY THAT ALL OF THE INFORMATION THAT I HAVE PROVIDED ON THIS APPLICATION IS TRUE AND ACCURATE.
THIS APPLICATION WILL BE CONSIDERED ACTIVE FOR A MAXIMUM OF THIRTY (30) DAYS. IF YOU WISH TO BE CONSIDERED FOR EMPLOYMENT
AFTER THAT TIME, YOU MUST REAPPLY. IF YOU ARE
SCHEDULED FOR AN INTERVIEW, YOU WILL BE ASKED
TO SIGN AND DATE A PRINTED COPY OF THIS APPLICATION
TO VERIFY AND AFFIRM YOUR ELECTRONIC SIGNATURE
AND ONLINE APPLICATION SUBMISSION.
