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AMA

APPLICATION OF EMPLOYMENT

* DOES NOT WORK ON MICROSOFT EDGE

Please Answer All Questions. Resumes Are Not A Substitute For A Completed Application.

We are an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state, or local laws.

THIS COMPANY IS AN AT-WILL EMPLOYER AS ALLOWED BY APPLICABLE STATE LAW. THIS MEANS THAT REGARDLESS OF ANY PROVISION IN THIS APPLICATION, IF HIRED, THE COMPANY OR I MAY TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME, FOR ANY REASON, WITH OR WITHOUT CAUSE OR NOTICE.

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Link Type

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Legal Acknowledgment

What is your availability or notice period?
Can you work overtime?
No
Yes
If under the age of 18, can you produce the necessary work certificate at the time of employment?
No
Yes
Will you now or in the future require immigration sponsorship for employment with American Medical Associates?
No
Yes
I authorize American Medical Associates to consider me for other job opportunities within the next 60 days.
No
Yes
Have you previously applied to American Medical Associates?
No
Yes
Have you previously been employed by American Medical Associates?
No
Yes
Are you a former/current extern or contractor?
No
Yes
Have you ever been convicted of a crime?
No
Yes
Have you ever been terminated from a job?
No
Yes
Has your employment ever been terminated upon mutual agreement?
No
Yes
Have you ever been given the choice to resign rather than be terminated?
No
Yes

Education

High School

Graduated?
No
Yes

College

Graduated?
No
Yes

Grad School

Graduated?
No
Yes

Trade School

Graduated?
No
Yes
Please list the names of your present and/or previous employers in chronological order with the present or most recent employer first. Provide information for at least the most recent ten(10) year period. You may include any verifiable work performed on a volunteer basis, internships, or military service. Your failure to completely respond to each inquire may disqualify you for consideration from employment. Do not answer "see resume".

Work History

Duties
May We Contact?
No
Yes
Dates Employed
Start Date
End Date
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Professional Reference

Professional Reference

Personal Reference

Personal Reference

Acknowledgment

1. I certify that all statements I have made on this application and on my resume or any other supplementary materials are true and correct. I acknowledge that any false statement or misrepresentation on this application, my resume, or supplementary materials will be cause for refusal to hire, or for immediate termination of employment at any time during the period of my employment. 2. I understand and agree that, if I am offered a position, it will be offered on condition that my employment will be at will and for no definite period, and that my employment may be terminated, at any time, with or without cause and with or without prior notice. 3. I understand that no supervisor or manager may alter or amend the above conditions except in writing, signed by a company officer.

I have read and understand the statements above and accept them as conditions of employment.

APPLICANT CERTIFICATION

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I understand that the Company may now have, or may establish, a drug-free workplace or drug and/or alcohol testing program consistent with applicable federal, state, and local law. If the Company has such a program and I am offered a conditional offer of employment, I understand that if a pre-employment (post-offer) drug and/or alcohol test is positive, the employment offer may be withdrawn. I agree to work under the conditions requiring a drug-free workplace, consistent with applicable federal, state, and local law. I also understand that all employees of the location, pursuant to the Company's policy and federal, state, and local law, may be subject to urinalysis and/or blood screening or other medically recognized tests designed to detect the presence of alcohol or illegal or controlled drugs. If employed, I understand that the taking of alcohol and/or drug tests is a condition of continual employment and I agree to undergo alcohol and drug testing consistent with the Company's policies and applicable federal, state, and local law. If employed by the Company, I understand and agree that the Company, to the extent permitted by federal, state, and local law, may exercise its right, without prior warning , or notice, to conduct investigations of property (including, but not limited to, files, lockers, desks, vehicle, and computers) and, in certain circumstances, my personal property. I understand and agree that as a condition of employment and to the extent permitted by federal, state, and local law, I may be required to sign a confidentiality, restrictive covenant, and/or conflict of interest statement. I certify that all the information on this application, my resume, or any supporting documents I may present during any interview is and will be complete and accurate to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of any information may result in disqualification from consideration for employment or, if employed, disciplinary action, up to and including immediate dismissal.

THIS COMPANY IS AN AT-WILL EMPLOYER AS ALLOWED BY APPLICABLE STATE LAW. THIS MEANS THAT REGARDLESS OF ANY PROVISION IN THIS APPLICATION, IF HIRED, THE COMPANY OR I MAY TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME, FOR ANY REASON. WITH OR WITHOUT CAUSE OR NOTICE. NOTHING IN THIS APPLICATION OR IN ANY DOCUMENT OR STATEMENT, WRITTEN OR ORAL, SHALL LIMIT THE RIGHT TQ TERMINATE EMPLOYMENT AT-WILL. NO OFFICER, EMPLOYEE OR REPRESENTATIVE OF THE COMPANY IS AUTHORIZED TO ENTER INTO AN AGREEMENT-EXPRESS OR IMPLIED-WITH ME OR ANY APPLICANT FOR EMPLOYMENT FOR A SPECIFIED PERIOD OF TIME UNLESS SUCH AN AGREEMENT IS IN A WRITTEN CONTRACT SIGNED BY THE CHIEF OPERATING OFFICER OF THE COMPANY. IF HIRED, I AGREE TO CONFORM TO THE RULES AND REGULATIONS OF THE COMPANY AND I UNDERSTAND THAT THE COMPANY HAS COMPLETE DISCRETION TO MODIFY SUCH RULES AND REGULATIONS AT ANY TIME, EXCEPT THAT IT WILL NOT MODIFY ITS POLICY OF EMPLOYMENT AT-WILL.

I authorize the Company or its agents to confirm all statements contained in this application and/or resume as it relates to the position I am seeking to the extent permitted by federal, state, or local law. I agree to complete any requisite authorization forms for the background investigation which may be permitted by federal, state and/or local law. If applicable and allowed by law, I will receive separate written notification regarding the Company's intent to obtain consumer reports. I authorize and consent to, without reservation, any party or agency contacted by this employer to furnish the above-mentioned information. I hereby release, discharge, and hold harmless, to the extent permitted by federal, state, and local law, any party delivering information to the Company or its duly authorized representative pursuant to this authorization from any liability, claims, charges, or causes of action which I may have as a result of the delivery or disclosure of the above requested information. l hereby release from liability the Company and its representative for seeking such information and all other persons, corporations, or organizations furnishing such information. Further, if hired, I authorize the company to provide truthful information concerning my employment to future employers and hold the company harmless for providing such information. If hired by this Company, I understand that I will be required to provide genuine documentation establishing my identity and eligibility to be legally employed in the United States by this Company. I also understand this Company employs only individuals who are legally eligible to work in the United States. THIS APPLICATION WILL BE CONSIDERED ACTIVE FOR A MAXIMUM OF SIXTY (60) DAYS. IF YOU WISH TO BE CONSIDERED FOR EMPLOYMENT AFTER THAT TIME, YOU MUST REAPPLY. I CERTIFY THAT ALL OF THE INFORMATION THAT I HAVE PROVIDED ON THIS APPLICATION IS TRUE, ACCURATE, AND COMPLETE. DO NOT SIGN UNTIL YOU HAVE READ ALL OF THE INFORMATION CONTAINED IN THE APPLICATION.

I acknowledge that I have read and understood American Medical Associates's Equal Employee Opportunities.

Digital Signature Acknowledgement: By clicking the"SUBMIT" button, you are signing your employment application electronically. You agree that by typing your full name, this action has the same legal validity and effect as your handwritten signature on the employment application and that it has the same meaning as your handwritten signature.