Online Employment Application

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  • Education History

    High School

  • College

  • Trade, Business or Correspondent School

  • Background

  • Employment Record

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  • I understand that misrepresentation or omission of facts in answer to the questions in the application may result in a refusal to hire or an immediate discharge upon discovery.

    I also understand that all statements made by me in connection with my application for employment may be checked. If I am employed by the practice I agree that, just as I have, if hired, the right to terminate my employment at any time, with or without cause, and with or without notice, the Company may terminate my employment at any time with or without cause or notice. I understand that no manager or representative of the Company other than a Partner of the Company has any authority to enter into any agreement for employment for any specified period of time or make any agreement contrary to the foregoing either now, in the past or in the future. I understand my employment is at-will and may be terminated for any reason. Any change in the at-will state of employment is not valid unless it is in writing and signed by an authorized representative of the Company. All applicants will be required to furnish proof of identity and legal work authorization to be considered for employment. All applications are kept on file for one year from the date of the record or personnel action, whichever is later. I acknowledge and agree that if any time during the hiring process or during my employment, I am subjected to any type of discrimination or harassment, I will contact the Company Rep immediately to obtain assistance in the resolution of such matters. I further acknowledge and agree that any dispute between me and the Company relating to my application for employment, my employment if hired and/or the separation of thereof, which cannot be resolved informally, shall be resolved by mediation in Lee County, Florida by an impartial mediator, selected in accordance with such rules as the exclusive remedy for any such dispute, including but not limited to claims of alleged discrimination. I understand that I must submit any claim to mediation no later than 365 calendar days following the date that I became aware of the conduct constituting the alleged claim. I further agree to waive any and all claims not raised through this procedure. I understand that this provision does not preclude me from filing a complaint or charge of discrimination with any federal, state, or local agency. I hereby represent and warrant that I have read and fully understand the foregoing and seek employment under these conditions of my own free will and in accordance with my own judgment.
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  • Permission to Contact Previous Employers

    I authorize the Company to contact my prior employers, including each of those employers listed in the Employment Record portions (except for the ones that I have indicated that you do not contact), and other sources of information, regarding my background, and I herby authorize and direct each such employer and source of information to answer any and all questions regarding my prior employment and background. I hereby agree to indemnify the Company and each of my prior employers listed in the Employment Record portions and each of the other sources of information contacted, and further agree to hold each and every one of them harmless from any claims arising from this authorization and direction.
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  • This field is for validation purposes and should be left unchanged.

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