APPLICANT'S CERTIFICATION AND ACKNOWLEDGEMENT
I hereby certify that all of the above information is true and complete; I understand that any misrepresentation,
falsification, or omission of information may result in the denial of employment or, if I am hired, may result in my
immediate dismissal, regardless of the time elapsed before discovery. If I am dismissed under these
circumstances, I further understand that I will be paid and receive benefits only through the day of termination.
I authorize St. John’s Episcopal School to investigate references, work records, evaluations, education, and
other matters related to my suitability for employment.
I authorize references and my former employers to disclose to the School any and all employment records,
performance reviews, letters, reports, and other information related to my life and employment, without giving me
prior notice of such disclosure.
In addition, I hereby release St. John’s Episcopal School, my former employers, references, and all other parties
from any and all claims, demands, or liabilities arising out of or in any way related to such investigation or
I waive the right to ever personally view any references given to the School.
Since I will be working with children, I understand that I must submit to a fingerprint check by the FBI and
possibly other federal and state authorities. I agree to cooperate fully in providing and recording as many sets
of my fingerprints as are necessary for such an investigation. I authorize St. John’s Episcopal School to
conduct a criminal records check.
I understand that this is only an application for employment and that no employment contract is being offered at
I understand that any offer of employment regarding certain job positions may depend on satisfactory completion
of a medical examination and/or drug and alcohol screening. I agree to sign a release of medical information
authorization form and to submit to a medical examination and/or drug and alcohol testing should St. John’s
Episcopal School make my offer of employment contingent upon successful completion of such examination or
I acknowledge that I have read all of the above statements and that I understand them.