List professional, trade, business, or civic associations and any offices held. Exclude memberships which would reveal sex, race, religion, national origin, age, color, disability, or any other similarly protected status.

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

I hereby authorize any reference, school, former employer, or any other person to disclose to Liberty Township upon request any and all documents, records, or other information that they may possess and I release them from liability for disclosing such information to Liberty Township. (This authorization shall remain in effect for a period of ninety (90) days from the date below.

I understand that if I meet all requirements and characteristics as indicated in the job description, hiring may be contingent upon successful completion of drug and alcohol test, background check, and a credit report, and physical. These costs will be borne by the Township.

I understand that if employed:

• I may be required to work additional or fewer hours at other than my current assignment as the needs of the Township require.
• My employment is subject to complying with those rules, regulations, and conditions as established by management.
• I will be required to conform to all existing and future policies and procedures of Liberty Township.
• Liberty Township reserves the right to change wages, hours, and working conditions, as deemed necessary.

I understand that if I am offered employment that I must provide appropriate documentation of my eligibility to work in the United States, in compliance with the Immigration Reform and Control Act. I also understand that if I fail to provide the documentation required by law prior to my first day of employment, I will not be allowed to begin work, and the offer of employment may be rescinded.

I understand that no employee is authorized to offer me employment, promise me salary increases, change of position, advancement, or any other advantages except those officially announced by the Liberty Township Board of Trustees.