Employment Application

List each job held. Start with your present or last job! Include Military Service assignments and volunteer activities.

List name, address, and telephone number of three professional references who are not related to you and are not previous supervisors. If not applicable, list three academic or personal references who are not related to you.

Upload your cover letter and resume in Microsoft Word (.doc, .docx) or as Adobe Acrobat Portable Document Format (.pdf).

Anti-Discrimination Notice. It is unlawful employment practice for an employer to fail or refuse to hire or discharge any individual, or otherwise discriminate against any individual with respect to that individual's terms and conditions of employment, because of such individual's race, color, religion, sex or national origin.

Allegany County Human Resources Development Commission, Inc. (HRDC) is subject to certain nondiscrimination and affirmative action record-keeping and reporting requirements which require the employer to invite employees to voluntarily self-identify their race/ethnicity. Submissions of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information obtained will be kept confidential and may only be used in accordance with the provisions of applicable federal laws, executive orders, and regulations including those which require the information summarized and reported to the Federal Government for civil rights enforcement purposes.

If you choose not to self-identify your race/ethnicity at this time, the federal government requires this employer to determine this information by visual survey and/or other available information. For civil rights monitoring and enforcement purposes only, all race/ethnicity information will be collected and reported in the seven categories identified below. The definitions for each category have been established by the federal government. If you choose to voluntarily self-identify, you may mark only one of the boxes presented below. Thank you for your cooperation.

Please read the following statement carefully before signing to indicate your understanding: I understand that if I receive a conditional job offer, and prior to beginning employment, I may be requested to undergo a pre-employment medical examination and/or drug and alcohol testing. In the event that I have a disability that will affect my ability to take the test, I will so inform Allegany County Human Resources Development Commission, Inc. (HRDC) prior to administration of the test so that a reasonable accommodation can be made. Allegany County Human Resources Development Commission, Inc. (HRDC) reserves the right to require medical documentation regarding the need for accommodation.

I certify that the facts and information set forth in this application are true and complete to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of facts on this application (or on any required documents) will be cause for denial of employment or immediate discipline, up to and including termination of employment, regardless of when or how discovered.

I understand and agree that, if hired, my employment is AT-WILL. THIS MEANS THAT, IF I AM HIRED, EITHER ALLEGANY COUNTY HUMAN RESOURCES DEVELOPMENT COMMISSION, Inc. (HRDC) OR I CAN END THE EMPLOYMENT RELATIONSHIP AT ANY TIME, WITH OR WITHOUT NOTICE, AND FOR ANY OR NO REASON.

I authorize investigation of all statements contained in this application for any employment related purpose. I release the listed references and all employers to provide you with any and all applicable information they may have. I hereby release these references and former employers from all liability for any information they may give to you, including but not limited to any defamation claims I may now have or will have against them.

I understand my application will be kept on file for a period of one (1) year.

UNDER MARYLAND LAW, AN EMPLOYER MAY NOT REQUIRE OR DEMAND, AS A CONDITION OF EMPLOYMENT, PROSPECTIVE EMPLOYMENT, OR CONTINUED EMPLOYMENT, THAT AN INDIVIDUAL SUBMIT TO OR TAKE A LIE DETECTOR OR SIMILAR TEST. AN EMPLOYER WHO VIOLATES THIS LAW IS GUILTY OF A MISDEMEANOR AND SUBJECT TO A FINE NOT EXCEEDING $100.