April 25, 2025

Applicant's Statement

I hereby affirm that the information provided on this application, and accompanying resume, if any, is true and complete to the best of my knowledge and belief.  I also understand that any false information, misrepresentations, or omissions may disqualify me from further consideration for employment and may result in dismissal if discovered at a later date.

I authorize a thorough investigation of my past employment and/or educational background, including discipline records, and agree to cooperate in such investigation.  I release from all liability and responsibility all persons and corporations or companies requesting or supplying such information and waive any right to notice of such disclosure.

I further understand that I will be required to submit to a drug screen, motor vehicle and criminal background screen and that the results of said drug screen, motor vehicle and criminal background screen may disqualify me from employment with Community Action.

I also further understand that a National Sex Offender Registry screen may be requested and that the results of said report may also disqualify me from employment with Community Action.

I agree that any civil action, including claims for discrimination under any law, must be filed with a court of proper jurisdiction within the earlier of the following dates or be forever barred: (1) for lawsuits requiring a Notice of Right to Sue from the EEOC, within thirty (30) days after the EEOC issues that Notice; or (2) for all other lawsuits, within (a) six (6) months of the event(s) giving rise to the claim, or (b) the time limit specified by statute, whichever is shorter. I waive any statute of limitations that exceeds this limit. If a civil action is not properly filed within this time period, I shall be barred from filing and maintaining such civil action to the same extent as if my claim was barred by the statute of limitations and such civil action shall not be maintained and shall be dismissed by the court. I agree that I am waiving my right to a longer statute of limitations that may apply under state or federal law. All obligations under this paragraph will survive any termination of my employment.