8. Personal Reference
Name:
Relationship:
Phone:
* Student Drivers: Referred by
**Choose One Please
Recruiter
Stevens Driver
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Website
Other
Name of Recruiter/Driver (if chosen above):
Other (if chosen above):
ACKNOWLEDGEMENT, AGREEMENT & RELEASE
I give Stevens Transportation, Inc. the right to investigate all references and to secure
additional information about me, if job-related. I release from liability
the Company and its representatives for seeking such information and all
other persons, corporations, or organization for furnishing such
information. A copy of this page serves as my authorization to
seek/provide this information. I agree to sign all documents and consent
forms which the Company deems necessary to verify the facts provided in
this application. I give my consent, and release from liability the
company and its representatives, to respond to any inquiries made about me
as part of a reference check by any subsequent or potential employer. I
authorize release of any information, including all information related to
my alcohol and controlled substance testing and training records conducted
under The Federal Highway Administration (FHWA) 49 CFR Parts 391 or 382,
by any past or current employers to Stevens Transport, Inc. I consent to
the procurement and use of any consumer reports, including reports from
DAC Services, Inc., deemed necessary by Stevens Transport, in their
consideration of my employment.
From time to time the Company may find it necessary to conduct investigations. If it does, employees are
expected to truthfully participate and cooperate in such investigations,
including submission to searches of property. Failure to do so may subject
employees to disciplinary action, which may include termination of
employment.
I understand that any offer of employment is contingent upon my ability to produce documentation verifying my identity
and legal authorization to be employed, as required by the Immigration
Reform & Control Act of 1986 (IACA).
I understand and agree that any misrepresented, inaccurate, misleading,
incomplete or omitted information provided by me in this application will
be sufficient cause for cancellation of this application and/or separation
from the Company's service if employed. Further, I understand that just as
I am free to resign at any time, for any reason, with or without prior
notice, the Company reserves the right to terminate my employment at any
time, for any reason, with or without prior notice. I understand that no
representative of this Company has the authority to make any verbal or
written assurances to the contrary. I recognize the employment
relationship to be an at-will relationship and not for a specific period
of time. This application represents the complete and final expression or
the intent of the parties and may not be modified except by a writing duty
executed by the undersigned and an officer of the Company.
I hereby agree to submit to binding arbitration all disputes and claims arising out
of the submission of this or other formal application. I further agree, in
the event that I am offered employment by the company, as a condition of
that employment all disputes that cannot be resolved by informal internal
resolution which might arise out of submission of this application or out
of my employment with the company, whether before, during or after such
employment will be submitted to binding arbitration in lieu of any Federal
or State investigative, administrative, civil or other legal Proceeding. I
agree to such arbitration shall be conducted in accordance with the
Stevens Transport Alternative Dispute Resolution Program. A copy of The
Program is available at Stevens Transport for review, upon request.
I have read carefully the above information, understand and accept the
contents thereof. I certify that this application was completed by me, and
that all entries on it and information in it are true and complete to the best of my knowledge.
SIGNATURE:
PLEASE PRESS "ACCEPT" ONLY ONCE TO SUBMIT YOUR APPLICATION!
