- This information will be used only for child labor law purposes
- Note: The Federal Immigration and Reform and Control Act of 1986 requires that a DHS Employment Eligibility Verification "FORM I-9" be completed for every new hire and that within 3 business days of beginning work every new hire must present to the employer documentation establishing his/her identity and authorization to work. This federal requirement must be satisfied as a condition of employment.
(Answer only if driving is a requirement of the job for which you are applying)
(Part 391.21 (b)(3))(Please provide your addresses of residence for the past seven years beginning with the most recent address.)
(May or may not be considered depending on job applied for.) Describe any educational degrees, skill, training or experience you believe are relevant to the job applied for:
(Please complete for all full-time or part-time employment beginning with most recent employer. You may include as part of your employment history any verified work performed on a volunteer basis)
(Please list three persons not related to you who know your qualifications.)
- (You may be required to furnish a copy of the agreement)
LIE DETECTOR TESTS
Massachusetts Applicants Note: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
Maryland Applicants Only: An employer may not require or demand, as a condition of prospective employment or continued employment, an individual submit to or take a lie detector or similar tests. An employer who violates this law is guilty of a misdemeanor and subject to a fine not exceeding $100. I have read and acknowledge this notice:
CRIMINAL RECORD INFORMATION
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