R.N / L.P.N. Sign on Bonus

I, the undersigned applicant, hereby authorize Residences at Deer Creek and Residences at Coffee Creek to contact all former and/or present employers, references, and any other agency, business, and/or individual that Residences at Deer Creek and Residences at Coffee Creek deems necessary to contact during its investigation of my background. I also agree to indemnify and hold harmless Residences at Deer Creek and Residences at Coffee Creek for any and all disclosures made to or by it in good faith relating to my employment.

I hereby affirm, under penalties of perjury, that all statements and representations made by me in this application are true to the best of my knowledge and belief. I hereby authorize Residences at Deer Creek and Residences at Coffee Creek to investigate any and all statements contained in this application and specifically direct and authorize all previous employers to release relevant information about me to Residences at Deer Creek and Residences at Coffee Creek, and further, I agree to indemnify and hold Residences at Deer Creek and Residences at Coffee Creek harmless as to any and all disclosure made to it or by it in good faith relating to my employment. I understand that as part of its investigation into my background, Residences at Deer Creek and Residences at Coffee Creek may conduct a criminal history check and that any offer of employment may be dependent upon satisfactory completion of a drug screen, physical exam, TB test, and satisfactory references. I further understand and agree that the position I am applying for is for no definite duration and may be terminated by me or by Residences at Deer Creek and Residences at Coffee Creek at any time without cause. Any and all answers are subject to verification by Residences at Deer Creek and Residences at Coffee Creek at any time before or after employment. Any false, misleading, or incomplete answer will be cause for immediate disqualification or for immediate termination in the event of employment.

Residences at Deer Creek and Residences at Coffee Creek is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, age, national origin, disability, participation in military service, or any other protected status.

A non-criminal justice organization or individual receiving a limited criminal history may not utilize it for purposes other than those stated in the request or which deny the subject any civil right to which the subject is entitled. IC 10-13-3-27: Any person who uses limited criminal history for any purpose not specified in the request commits a Class A misdemeanor offense.