WARD AND SMITH, P.A.

Application for Employment

We appreciate your interest in Ward and Smith, P.A. The following information is needed in order to help us make the best possible decision in regard to your employment with us.

We would like to assure you that Ward and Smith, P.A. is an equal opportunity employer and does not discriminate on the basis of age, race, color, religion, sex, disability, national origin, or any other legally protected status.

We are required by the Americans with Disabilities Act to provide equal opportunities to qualified applicants and employees who are able to perform the essential functions of the job, with or without reasonable accommodation. If you will require an accommodation to complete this application or participate in an interview, feel free to notify the Legal Administrator.

All employment with Ward and Smith, P.A. is "at-will" which means anyone's employment can be terminated at any time with or without stated cause or reason. This application is in no way an offer of employment to you but is your request for consideration for potential employment.

All portions of this application must be completed. Please print all answers. This application will remain active for a period of six months.

If employed, I agree to adhere to all Ward and Smith, P.A. rules and regulations and to abide at all times by Ward and Smith, P.A. personnel policies. In further consideration of my employment with Ward and Smith, P.A., I understand that all attorneys and employees of the firm are required by the rules governing professional conduct to keep all matters relating to clients and Ward and Smith, P.A. absolutely confidential. I agree that if employed, I will never, during or after employment with Ward and Smith, P.A. reveal to any person any information whatsoever with respect to any clients' or firm's personal or business matters. If employed, I acknowledge and agree that my employment is not guaranteed for any definite period of time, that there is no contract of employment, and that my employment will be on an "at-will" basis, meaning that it may be terminated at any time with or without any reason by Ward and Smith, P.A. or me. If employed, I understand that no supervisor I may have will have authority to change the "at-will" nature of my employment with Ward and Smith, P.A.

I acknowledge and agree that this application is only an application and cannot be a contract, that no representations have been made to me concerning employment or future employment with Ward and Smith, P.A., and that no other promises have been made to me concerning job security or long-term advancement opportunities with Ward and Smith, P.A.

I hereby certify that the facts set forth in this application are true and correct. I understand and acknowledge that falsification, misrepresentation or concealment of any information with regard to this application may disqualify me from further consideration for employment or may result in my immediate discharge if discovered at a later date. I hereby authorize Ward and Smith, P.A. to contact the employers and references named by me in this application and hereby authorize those employers and references to give Ward and Smith, P.A. any and all information concerning my previous employment or any other pertinent information about me they may have. I understand that Ward and Smith, P.A. may act on the information received from these references at its discretion and I hereby release Ward and Smith P.A. and all such employers and references from any liability whatsoever in furnishing this information.

I hereby agree to submit to and grant Ward and Smith, P.A. the authority to conduct, at Ward and Smith's discretion, a pre-employment investigation, which may include but is not limited to drug testing, a post offer medical examination, an investigation of my credit history with an appropriate credit reference agency and/or with any of my creditors, or such other investigation(s) into the information contained in this application or my background or current status was Ward and Smith, P.A. determines to be necessary. I understand that my application will not be considered complete before completion of any such investigation or examination, including receipt by Ward and Smith, P.A. of any reports or results therefrom, if such is required by Ward and Smith, P.A.

I understand that Ward and Smith, P.A. may act on any such results and reports and that these results and reports will be the property of Ward and Smith, P.A. I hereby release Ward and Smith, P.A. and all providers of such information from any liability whatsoever in furnishing or using the above described information. I understand that the possession, use, and/or working under the influence of alcohol, marijuana, cocaine and other chemical substances is absolutely forbidden and that violation of this policy may result in refusal of or separation from employment. I also understand that failure to voluntarily disclose a chemical dependency may result in refusal of or separation from employment.

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