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FALSIFICATION OF RECORDS
I completed this application and I certify that the information in this application is correct to the best of my knowledge. I
understand that falsification of this application or omission of requested information in any detail is grounds for
disqualification from further consideration or for dismissal from employment.
EMPLOYMENT AT WILL
I will follow the rules and regulations of Oakland Heights as communicated to me. I understand that in no event shall my
hiring be considered as creating a contractual relationship between myself and Oakland Heights. Unless otherwise provided
in writing, the employment relationship shall be defined as "employment at will," and either party may dissolve the
relationship without cause. I further understand that no employee or supervisor, except the Administrator or designee, has
the authority to enter into any agreement or contract of employment for any specific terms of employment such as length of
service, future salary increases or agreement contrary to this application. Furthermore, I understand that any such agreement
entered into by the Administrator or designee will not be enforceable unless it is in writing.
CONDITIONAL OFFER OF EMPLOYMENT
If I receive a conditional offer of employment, I understand that I may be the subject of drug screening, criminal background
study and/or physical screening and evaluation. I hereby consent to such screening and record checks.
PROOF OF RIGHT TO WORK
If I am offered a position with this center, I understand that as a condition of employment I will be required to prove identity
and right to work as required by the Immigration Reform and Control Act of 1986.
PARTICIPATION IN GOVERNMENT PROGRAMS
I agree to inform my supervisor or Administrator if I become subject to exclusion from any Federal or State Health Care
Program [as defined by 42 U.S.C. 1320a-7] as a vendor, provider or employee or contractor of a participating provider or if I
become aware that I may be subject to such exclusion.
RELEASE OF INFORMATION
I acknowledge that consideration for employment is contingent on the results of a reference and background check.
Therefore, I hereby authorize Oakland Heights to (1) investigate the truthfulness of all statements made on this application;
(2) contact my former employers and other listed references or any other persons who can verify information; and (3)
discuss the results of any investigation with other employees of Oakland Heights involved in the hiring process. In
addition, I give my consent for all contacted persons, including former employers, to provide information concerning this
application, and I release each such person from liability for providing information to Oakland Heights.
FAIR TREATMENT PROGRAM
As a term and condition of my employment, and unless covered by an individual employment contract or a collective
bargaining agreement with different dispute resolution provisions, I agree to waive my right to a jury trial in any action or
proceeding related to my employment with Oakland Heights. I am doing so voluntarily and knowingly. I understand that I
have the right to consult with counsel before signing this document. I agree that all claims and disputes relating to my
employment with Oakland Heights shall be decided by a mediator or arbitrator selected in accordance with the rules and
procedures established by the national Arbitration Forum.