Application For Employment Job at Granger Demo Account
Samron Midwest Contracting, Inc.
P.O.Box 1555
1510 North 7th Street
Murphysboro, IL 62966
(618) 687-5500 (Phone)
(618) 687-5153 (Fax)
www.samron.com
Authorization
I certify that the facts contained in this application are true and complete to the best of my knowledge and
understand that, if employed, false statements on this application shall be grounds for dismissal.
I authorize investigation of all statements contained on this application and the references and employers listed
above to give you any and all information concerning my previous employment and any pertinent information they
may have, personal or otherwise, and release the company from all liability for any damage that may result from
utilization of such information.
I also understand and agree that no representative of the company has any authority to enter into any agreement
for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is
in writing and signed by an authorized company representative.
This waiver does not permit the release or use of disability-related or medical information in a manner prohibited
by the Americans with Disabilities Act (ADA) and other relevant federal and state laws
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